JP2009502352A - Surgical device - Google Patents

Abstract

  A surgical device is provided that includes a jaw portion that includes a first jaw portion and a second jaw portion that is movable relative to the first jaw portion. The surgical device also includes a shaft portion coupled to the proximal end of the jaw portion. The drive unit is configured to move the jaw portion and the shaft portion relative to each other. The drive can be configured to pivot relative to the shaft portion about a pivot axis perpendicular to the first and second longitudinal axes defined by the jaw portion and the shaft portion, respectively. The drive can also be configured to rotate at least a portion of the jaw portion relative to the shaft portion about the first longitudinal axis. Advantageously, the surgical device comprises a surgical member such as a cutting element and / or a stapling element disposed in the first jaw, for example.

Description

[Cross-reference of related applications]
In particular, the present invention relates to Patent Document 1 filed on June 14, 2002, Patent Document 2 filed on June 11, 2003, Patent Document 3 filed on November 30, 2001, and June 22, 2001. No. 09 / 324,451, filed on Apr. 17, 2001, U.S. Patent Application No. 09 / 324,451, filed Nov. 28, 2000, U.S. Pat. Patent application No. 7/2001, filed as Nov. 13, 2001, patent application No. 09 / 324,452 issued on Jun. 2, 1999, and granted on September 3, 2002. Patent Document 8, US Patent Application Publication No. 09 / 351,534 filed on July 12, 1999, which became a patent on July 24, 2001, and Patent Application Publication on February 22, 2000 09/510 Patent Application No. 923, filed on February 11, 2003 and patented on February 11, 2003; US Patent Application Publication No. 09 / 510,927 filed on February 22, 2000; patent granted on April 6, 2004 Each of which is expressly incorporated herein by reference in its entirety.

  The present invention relates to a surgical device. More particularly, the present invention relates to a powered articulating device that clamps, cuts, and staples tissue.

  One type of surgical device is a device that clamps, cuts, and staples in a straight line. Such devices can be used in surgical procedures that remove cancerous or abnormal tissue from the gastrointestinal tract. One conventional straight clamping, cutting and stapling instrument is shown in FIG. The device has a pistol grip style structure with an elongated shaft and a distal portion. The distal portion comprises a pair of scissor style gripping elements that clamp and close the open end of the colon. In this device, one of two scissor-style gripping elements, such as an anvil portion, moves or pivots with respect to the entire structure, while the other gripping element remains fixed with respect to the entire structure. The operation of this scissor device (turning of the anvil part) is controlled by a gripping trigger maintained on the handle.

  In addition to the scissor device, the distal portion also includes a stapling mechanism. The fixed gripping element of the scissor mechanism comprises a staple cartridge receiving area and a mechanism for punching staples through the clamped end of the tissue against the anvil portion, thereby sealing the previously open end. The scissor elements can be formed integrally with the shaft or removable so that the various scissor elements and stapling elements can be interchangeable.

  One problem with the aforementioned surgical devices, particularly with the aforementioned straight clamping, cutting and stapling devices as shown in FIG. 1, is that it is difficult to manipulate the opposing jaws within the patient. It is possible that The surgeon may need to move the opposing jaws at various angles to place the desired tissue between the opposing jaws. In general, however, it is also desirable to make the patient's incision as small as possible, and the small size incision limits the angle at which the opposing jaws can be manipulated.

Another problem with the aforementioned surgical device, particularly with the aforementioned straight clamping, cutting and stapling device as shown in FIG. 1, is that the opposing jaws may not have sufficient hemostasis. That is. In particular, the opposing jaws of the aforementioned surgical device are not clamped together with sufficient force, thereby reducing the effectiveness of the surgical device.
US Patent Application No. 60 / 388,644 US Patent Application Publication No. 10 / 460,291 US Patent Application Publication No. 09 / 999,546 US Patent Application No. 09 / 887,789 US Patent Application No. 09 / 836,781 US Patent Application Publication No. 09 / 723,715 US Pat. No. 6,315,184 US Pat. No. 6,443,973 US Pat. No. 6,284,087 US Pat. No. 6,517,565 US Pat. No. 6,716,233 Applicant's co-pending provisional patent application indicated as patent attorney number 11443/210 US Patent Application Publication No. 10 / 099,634

  Therefore, it is considered necessary to improve the operability of the device that is tightened, cut and stapled. In addition, a clamping, cutting, and stapling device that provides additional clamping force is considered necessary.

  According to an exemplary embodiment of the present invention, a surgical device is provided that includes a jaw portion that is pivotally connected to a shaft portion around a hinge. The hinge defines the axis of rotation of these components perpendicular to one or both of the jaw part and the shaft part. The jaw portion or a portion thereof can also be rotatable relative to the shaft portion about the longitudinal axis of the jaw portion.

  The chin portion includes a first chin portion and a second chin portion. The second jaw part is arranged in a relationship facing the first jaw part. The first jaw part can be pivotably connected to the second jaw part. The device may also comprise at least one of a cutting element and a stapling element disposed within a second jaw, preferably a blade rotatably mounted on the staple driving wedge. The cutting element and / or stapling element is for performing at least one of cutting and stapling a section of tissue disposed between the first jaw and the second jaw. , And can be configured to move between the distal and proximal ends of the second jaw.

  According to an exemplary embodiment of the present invention, a surgical device comprising a chin portion is provided. The chin portion includes a first chin portion and a second chin portion that is movable relative to the first chin portion. The surgical device also includes a shaft portion coupled to the proximal end of the jaw portion. The surgical device further includes a drive configured to cause relative movement of the jaw portion and the shaft portion. The jaw portion defines a first longitudinal axis and the shaft portion defines a second longitudinal axis. The drive can be configured to pivot the jaw relative to the shaft portion about a pivot axis perpendicular to the first and second longitudinal axes. The first and second jaws can be movable relative to each other in one plane, and the pivot axis is arranged parallel to the plane. Also, according to an exemplary embodiment of the present invention, the drive can be configured to pivot at least a portion of the jaw portion relative to the shaft portion about the first longitudinal axis.

  The drive can be configured to be driven by a first rotatable drive shaft and a second rotatable drive shaft. For example, the drive can be configured to pivot the jaw portion relative to the shaft portion about the pivot axis by rotating first and second rotatable drive shafts in opposite directions relative to each other. The drive section also rotates at least a portion of the jaw portion about the first longitudinal axis relative to the shaft portion by rotating the first and second rotatable drive shafts in the same direction relative to each other. Can be configured. Further, the drive unit rotates the first rotatable drive shaft without rotating the second rotatable drive shaft, thereby moving the first jaw part and the second jaw part relative to each other. Can be configured.

  The surgical device can include a surgical member disposed within the first jaw. The surgical member can comprise a cutting element and / or a stapling element. The drive unit can be configured to relatively move the surgical member within the first jaw by rotating the second rotatable drive shaft without rotating the first rotatable drive shaft.

  According to an exemplary embodiment of the present invention, a jaw part comprising a first jaw part and a second jaw part movable relative to the first jaw part, and connected to the proximal end of the jaw part Selective rotation of the shaft portion and the first and second rotatable drive shafts to be driven by the first and second rotatable drive shafts that cause the surgical device to perform at least four different functions The drive unit made has four different functions, for example the jaw part, the first jaw part, the second jaw part and the first part of the shaft part, the jaw part, the first jaw part There is provided a surgical device comprising a second jaw portion, and a drive portion that is movement relative to a second of the shaft portions.

  The jaw portion can define a first longitudinal axis, and the first of the at least four different functions is the rotation of at least a portion of the jaw portion relative to the shaft portion about the first longitudinal axis. including. The drive is driven by rotation of the first and second rotatable drive shafts in the same direction relative to each other so as to rotate at least a portion of the jaw portion about the first longitudinal axis relative to the shaft portion. Configured to be. The shaft portion can define a second longitudinal axis, and a second of the at least four different functions is to place the jaw portion around the pivot axis perpendicular to the second longitudinal axis into the shaft portion. Including swiveling relative to each other. The drive is configured to be driven by rotation of the first and second rotatable drive shafts in opposite directions with respect to each other so as to pivot the jaw portion relative to the shaft portion about the pivot axis. The A third of the at least four different functions can include moving the first jaw relative to the second jaw. The drive unit is configured to be driven by the first rotatable drive shaft without rotating the second rotatable drive shaft in order to move the first jaw part and the second jaw part relative to each other. Is done. In addition, the surgical device can also comprise a surgical member comprising, for example, a cutting and / or stapling element disposed within the first jaw, the fourth of the at least four different functions being the first Including relative movement of the surgical member within the jaw of one. The drive unit is driven by rotating the second rotatable drive shaft without rotating the first rotatable drive shaft so as to relatively move the surgical member within the first jaw. Configured as follows.

  FIG. 2 (b) is a schematic diagram illustrating some of the components of the surgical device 11 according to an exemplary embodiment of the present invention. The surgical device 11 is configured to be particularly suitable for insertion into a patient's body, for example via a cannula (not shown). In the illustrated embodiment, the surgical device 11 is a device that clamps, cuts, and staples. The surgical device 11 includes a jaw portion 11a that is pivotally connected to the shaft portion 11b by a hinge portion 11c. The jaw portion 11a includes a first jaw portion 50 having a distal end portion 50a and a proximal end portion 50b, and a second jaw portion 80 having a distal end portion 80a and a proximal end portion 80b. The first jaw portion 50 and the second jaw portion 80 are pivotally connected to each other at or near their respective proximal ends 50b, 80b. In the illustrated exemplary embodiment, the first jaw portion 50 and the second jaw portion 80 pivot relative to each other about a pivot axis A oriented perpendicular to the page.

  As described above, the jaw portion 11a is pivotally connected to the shaft portion 11b by the hinge portion 11c. Specifically, the jaw portion 11a is pivotable with respect to the shaft portion 11b around the pivot axis B, and the pivot axis B is at the jaw portion 11a and the shaft portion 11b or any position therebetween. It can arrange | position in the position of the arbitrary circumferential directions with respect to the jaw part 11a and the shaft part 11b. In the illustrated exemplary embodiment, the pivot axis B is oriented vertically in the illustrated view so that the jaw portion 11a pivots in a plane perpendicular to the page during articulation. It should be understood that in other exemplary embodiments, the pivot axis B can have different orientations so that the jaws 11a can pivot in different planes. The jaw portion 11a can be pivoted at and between any angle relative to the shaft portion 11b so that it can be selectively placed as desired during use. A plurality of pivot axes (the longitudinal axis of the shaft portion 11b is shown as axis D in FIG. 2B) relative to the longitudinal axis of the shaft portion 11b can be provided. For example, in various embodiments, the jaw 11a can be rotatable relative to the shaft portion 11b about its longitudinal axis D, or a plurality of pivot axes that are perpendicular to the longitudinal axis D Around the shaft portion 11b.

  The shaft portion 11b can include a distal portion 1101 and a proximal portion 1102 to which the jaw portion 11a is coupled. The proximal portion 1102 of the shaft portion 11b can include a handle 1103 that can be used by a user to grasp the surgical device 11. At the most proximal end of the proximal portion 1102, the shaft portion 11b is coupled to a flexible shaft (shown in more detail below), such as a quick-connect coupling. A coupling element 1104 can be provided.

  The second jaw portion 80 includes a tightening surface 106. The second jaw 80 also includes a cutting and stapling element 104 that can form at least a portion of the clamping surface 106 of the second jaw 80. The first jaw portion 50 includes an anvil member 700 that faces the second jaw portion 80. The anvil member 700 includes a clamping surface 108 that clamps the portion of tissue that is cut and stapled along the clamping surface 106 of the second jaw 80. As described in more detail below, the cutting and stapling element 104 cuts a portion of tissue when the first jaw 50 and the second jaw 80 are, for example, in a fully closed position, Configured to staple. Additional features of the cutting and stapling element 104 according to one embodiment are further described, for example, in reference to FIGS. 3 (f) and 3 (g) below, and US Pat. Illustrated and described in U.S. Patent No. 6,053,086, filed on June 11, 1980, each of which is expressly incorporated herein by reference in its entirety, each as specified above.

  Using various drives, for example, the jaw portion 11a of the surgical device 11 is pivoted with respect to the shaft portion 11b, and the jaw portion 11a or part thereof is rotated with respect to the shaft portion 11b about its longitudinal axis. The operations such as turning the first jaw portion 50 with respect to the second jaw portion 80 and feeding the staple cartridge can be driven. According to one embodiment of the present invention, these functions can be performed by coupling the surgical device 11 to a flexible shaft having two rotatable drive shafts, while in other embodiments It should be understood that different types and / or different numbers of drive components can be used.

  FIG. 2 (b) shows that the surgical device 11 uses first and second drives 88 and 98, each of two rotatable drive shafts, eg flexible drive shafts, respectively. 1 schematically illustrates one embodiment coupled to one. For example, the first drive unit 88 can operate to move the first jaw unit 50 and the second jaw unit 80 relative to each other, for example. The first drive unit 88 can include any type of drive mechanism that can move the first jaw unit 50 and the second jaw unit 80 relative to each other. The first driver 88 can be at least partially located at the proximal end 80 b of the second jaw 80 and can be coupled to the proximal end 50 b of the first jaw 50. The first driving unit 88 can be engaged with the proximal end portion 50 b of the first jaw unit 50 so as to open and close the first jaw unit 50 with respect to the second jaw unit 80. Further, the first drive 88 can extend through the shaft portion 11 b of the surgical device 11 to the first drive socket 654. The first drive socket 654 of the first drive unit 88 is connected to the first motor 96 by the first drive shaft 94. As described in more detail below, the first drive 88 is used to perform other operations of the surgical device 11 when engaged by the first motor 96 via the first drive shaft 94. In addition, the first jaw portion 50 can be operated to open and close with respect to the second jaw portion 80.

  The second jaw unit 80 also includes a second drive unit 98. The second drive 98 can also extend through the shaft portion 11 b of the surgical device 11 to the second drive socket 694. A second drive socket 694 is connected to the second motor 100 by the second drive shaft 102. The second drive 98, when engaged by the second motor 100 via the second drive shaft 102, cuts a portion of the tissue 52 in addition to performing other operations of the surgical device 11. Operable to drive the cutting and stapling element 104 for stapling.

  Two drive sockets, eg, a first drive socket 654 and a second drive socket 694, and two corresponding drive shafts, eg, a first drive shaft 94 and a second drive shaft 102, are part of the surgical device 11. Although illustrated as being and for purposes of clamping, cutting, and stapling portions of tissue, any suitable number of drive sockets and drive shafts can be provided. For example, a single drive shaft can be provided to perform the functions of the surgical device 11 described above.

  In one embodiment, two drive shafts, eg, first drive shaft 94 and second drive shaft 102, are configured to be used to move jaw portion 11a relative to shaft portion 11b as well. The An example of this type of embodiment is shown, for example, in FIGS. 3 (a) to 3 (e) and described further below. Instead, and as shown in FIG. 2 (b), the surgical device 11 includes a third driver 201 and a fourth driver used to move the jaw portion 11a relative to the shaft portion 11b. 202 can also be provided. For example, the third drive unit 201 can be configured to pivot the jaw portion 11a around the axis B with respect to the shaft portion 11b, and the fourth drive unit 202 can move the jaw portion 11a to the shaft portion 11b. It can be configured to rotate about the longitudinal axis D. In one embodiment, the third and fourth drive portions 201, 202 are rotatable drive shafts that extend through the shaft portion 11b of the surgical device 11 to the third and fourth drive sockets 2011, 2021, respectively. is there. The third drive socket 2011 is connected to the third motor 2013 by the third drive shaft 2012. When the third drive unit 201 is engaged by the third motor 2013 via the third drive shaft 2012, the third drive unit 201 operates to rotate the jaw portion 11a around the axis B with respect to the shaft portion 11b. . The fourth drive socket 2021 is connected to the fourth motor 2023 by the fourth drive shaft 2022. When the fourth drive unit 202 is engaged by the fourth motor 2023 via the fourth drive shaft 2022, the jaw part 11a is rotated about its longitudinal axis D relative to the shaft 11b. Operate.

  The drive shaft, such as the first and second rotatable drive shafts 94 and 102, and any other shafts are flexible drive shafts such as the flexible drive shaft 1620 shown in FIG. 2 (a). Can be accommodated inside. Other types of flexible drive shafts can also be used. For example, the drive shaft can be housed in a flexible drive shaft of the type described and illustrated in US Pat.

  Referring to FIG. 2 (b), the surgical device 11 can also include a memory module 6041. In one embodiment, the memory module 6041 is coupled to or integral with the cutting and stapling element 104. Memory module 6041 is coupled to data connector 1272 by a data transfer cable 1278. Further features of these components are specified in connection with FIGS. 3 (f) and 7.

  Further, FIG. 2 (b) also shows a connecting element 1104. The coupling element 1104 can comprise a quick coupling sleeve 713 having a quick coupling slot 713a that engages a complementary quick coupling element 1664 of the flexible drive shaft 1620, which is described in further detail below. In order to maintain the quick connection element 1664 of the flexible drive shaft 1620 in the quick connection slot 713a of the quick connection sleeve 713, the connection element 1104 can also comprise a spring.

  According to an exemplary embodiment of the invention, the surgical device 11 is as an attachment to an electromechanical surgical system, such as an electromechanical drive component 1610 having a motor system as shown in FIG. It can be configured or integral with it. In this exemplary embodiment, it will be appreciated that any suitable number of motors can be provided, and the motors can operate via battery power, line current, DC power, electronically controlled DC power, etc. I want. It should also be understood that the motor is coupled to a DC power supply that is connected to line current so that operating current can be supplied to the motor. In another exemplary embodiment, the surgical device can be an attachment to a mechanical drive system or can be integral therewith.

  FIG. 3 (a) is a perspective view of a surgical device 11 according to one embodiment of the present invention. As specified above, FIGS. 3 (a) to 3 (e) show that two drive shafts move the jaw portion 11a relative to the shaft portion 11b and rotate the jaw portion 11 about its longitudinal axis. FIG. 3 illustrates one embodiment of the present invention configured to be used to move a first jaw 50 relative to a second jaw 80, staple and cut out a cartridge for cutting. . In the position shown in FIG. 3A, the jaw portion 11a is disposed at an angle of approximately 60 degrees with respect to the shaft portion 11b. The jaw 11a can be properly positioned according to the incision made in the patient and the location of the tissue that it is desired to clamp, cut and staple.

  FIG. 3 (b) is a rear perspective view showing some of the internal components of the surgical device 11 according to an exemplary embodiment of the present invention. The outer body of the surgical device 11 is shown in phantom lines. As shown, jaw portion 11a is in an initial position, where jaw portion 11a is axially aligned with shaft portion 11b.

  FIG. 3 (b) shows a first rotatable drive shaft 500, which can be axially rotatable within the shaft portion 11b. A gear element 502 is coupled to the first rotatable drive shaft 500. The gear element 502 rotates about the longitudinal axis and is in meshing engagement with the gear element 504. The gear element 504 is held in place by a pin 505, the central axis of which is coaxial with the pivot axis B, and the jaw portion 11a pivots around the shaft portion 11b.

  The gear element 504 also meshes with the gear element 506 in the jaw portion 11a. Gear element 506 is coupled to gear element 510 by shaft 508. Gear element 506, gear element 510, and shaft 508 rotate within jaw portion 11a about a longitudinal axis defined by the central axis of shaft 508. The gear element 510 is in meshing engagement with a gear element 512 that rotates about a pin 513 disposed longitudinally within the jaw portion 11a. Gear element 512 is in meshing engagement with gear element 514. The gear element 514 has a shaft portion that extends distally with respect to the set of teeth 516. The teeth 516 are selectively engageable with correspondingly formed openings in the plate 518, and the plate 518 is keyed to the internal surface of the surgical device 11 to prevent relative rotation of the plate 518. ing. The plate 518 has a first position where a correspondingly formed opening in the plate 518 is engaged and secured with the teeth 516, and the plate 518 is moved distally with respect to the first position so that the plate 518 A correspondingly formed opening is axially movable between a second position that does not engage the tooth 516.

  A threaded screw 520 extends distally from the shaft portion carrying gear 514 and teeth 516. A threaded screw 520 is disposed longitudinally and is configured to rotate about the longitudinal axis as the gear 514 rotates. Push block 522 is attached to threaded screw 520. The push block 522 is keyed to the internal surface of the surgical device 11 to prevent its relative rotation. A pair of rollers 524 are rotatably coupled to the lower distal end of push block 522. A pair of rollers 524 sits in the respective slots 5011 on each side of the upper jaw 50. The upper jaw portion 50 and the slot 5011 are shown by dotted lines in FIG.

  FIG. 3 (b) also shows a second rotatable drive shaft 550, which can be axially rotatable within the shaft portion 11b. A gear element 552 is coupled to the second rotatable drive shaft 550. The gear element 552 rotates about the longitudinal axis and is in meshing engagement with the gear element 554. The gear element 554 is held in place by a pin 505, the central axis of which is concentric with the pivot axis B, and the jaw portion 11a pivots around the shaft portion 11b.

  The gear element 554 also meshes with the gear element 556 in the jaw portion 11a. Gear element 556 is connected to gear element 560 by shaft 558. Gear element 556, gear element 560, and shaft 558 rotate within jaw portion 11a about a longitudinal axis defined by the central axis of shaft 558. Gear element 560 is in meshing engagement with gear element 562a mounted at the proximal end of pin 513. The gear element 562a is non-rotatably mounted on the pin 513 and is thus configured to rotate with the pin 513, the pin 513 extending longitudinally within the jaw portion 11a. Further, the gear element 562b is adapted to be non-rotatably mounted to the distal end of the pin 513. Accordingly, the gear element 562b is also configured to rotate with the pin 513.

  Gear element 562b has a shaft portion extending distally and includes a set of teeth 5661 (hidden from FIG. 3 (b) but shown in FIG. 3 (d)). The teeth 5661 are selectively engageable with corresponding openings formed in the plate 518. As specified above, the plate 518 is keyed to the internal surface of the surgical device 11 to prevent its relative rotation, and a correspondingly formed opening in the plate 518 engages the tooth 5661. And a second position where the plate 518 is moved distally relative to the first position and the correspondingly formed opening in the plate 518 does not engage the teeth 5661. It can move in the axial direction between.

  The gear element 562b is in meshing engagement with the gear element 564. A first longitudinal rod 566 extends distally from the gear 564. A first longitudinal rod 566 is attached to a second longitudinal rod 568. The second longitudinal rod 568 has a shoulder 572. There is a spring between the first longitudinal rod 566 and the shoulder 572 of the second longitudinal rod 568. The distal end 574 of the second longitudinal rod 568 is configured to engage a respective opening in the wedge drive 605. The wedge drive 605 rotates to drive a wedge to be stapled / cut (described in further detail below) along the staple cartridge.

  These components are also shown in various other figures. For example, FIG. 3C is a side perspective view showing some of the internal components of the surgical device 11. As shown, the jaw portion 11a is pivoted, for example, articulated with respect to the shaft portion 11b. Further, FIG. 3 (d) is a perspective view showing a jaw portion 11a that is further swiveled, for example, articulated with respect to the shaft portion 11b. FIG. 3 (e) is a bottom perspective view showing the jaw portion 11a that is turned, for example, articulated with respect to the shaft portion 11b.

  As specified above, the surgical device 11 can also include an element 104 for cutting and stapling. In one embodiment, the stapling and cutting element 104 is a staple cartridge. FIG. 3F is an exploded view of the replaceable staple cartridge 600. The replaceable staple cartridge 600 is a type of stapling / cutting device that can be used as the cutting and stapling element 104 in the exemplary embodiment of the invention shown in FIGS. 3 (a) to 3 (e). It is. The replaceable staple cartridge 600 includes a staple tray 604. The staple tray 604 has a slot 604i at its proximal end 604d where the memory module 6041 is held by a memory module holder 6042. The memory module 6041, for example, November 28, 2000, now patented as US Pat. No. 6,793,652 on September 21, 2004, each of which is expressly incorporated herein by reference in its entirety. Patent Document 6 filed on April 17, 2001, Patent Document 5 filed on April 17, 2001, Patent Document 4 filed on June 22, 2001, and Patent Document 13 filed on March 15, 2002. Information can be stored. A wedge drive 605 is configured to be rotatably disposed through a central channel 604e of the staple tray 604. In particular, the wedge drive 605 has a distal end 605a configured to be rotatably mounted within a distal orifice 604a of the staple tray 604. The wedge drive 605 includes an outer threaded region 605b, a non-threaded portion 605c that extends rotatably through the proximal orifice 604b at the proximal end 604b of the staple tray 604, the first Also provided is a proximally facing opening 605d that receives the distal end 574 of the two longitudinal rods 568. The proximal facing opening 605d and the distal end 574 of the second longitudinal rod 568 are inserted into the distal end 574 of the second longitudinal rod 568, for example, into the proximal facing opening 605d. When received, they are non-rotatably connected to each other.

  The replaceable staple cartridge 600 also includes a wedge 603 having an internally threaded bore 603a. A region 605 b threaded outside the wedge drive 605 is configured to extend through a bore 603 a threaded inside the wedge 603. The thread of the bore 603a threaded inside the wedge 603 matches the thread of the region 603b threaded outside the wedge drive 605. As discussed further below, upon rotation of the wedge drive 605, the wedge 603 moves through the central channel 604e between the distal end 604c of the staple tray 604 and the proximal end 604d of the staple tray 604. To do.

  The staple tray 604 also includes a plurality of longitudinally arranged slots 604f in opposing walls 604g of the central channel 604e. A staple pusher 607 is configured to be slidably disposed in the slot 604f on each side of the central channel 604e. More particularly, each staple pusher 607 has a top surface 607a that extends longitudinally between two rows 607b of staple pushing fingers 607c. Staple pushing fingers 607c are configured such that each staple pushing finger 607c in row 607b abutting against wall 604g of staple tray 604 is maintained to be slidable longitudinally within a corresponding slot 604f in wall 604g. Is done. A staple pushing finger 607 c is disposed on the slot 604 h of the staple tray 604. The slot 604h of the staple tray 604 accommodates a plurality of stops, for example, a plurality of staples 606. Each of the staples 606 includes a butt 606a and a pair of prongs 606b.

  The wedge 603 also includes a pair of beveled edges 603b that slidably engage the respective upper surface 607a of the staple pusher 607. As the wedge 603 moves through the central channel 604e from the distal end 604c to the proximal end 604d of the staple tray 604, the pair of beveled edges 603b of the wedge 603 causes the staple pushing fingers 607c of the staple pusher 607 to move. Is slidably engaged with the respective upper surface 607a of the staple pusher 607 for pushing the staples continuously into the slots 604h of the staple tray 604 and thus forcing the staples 606 therefrom. The upper portion 611 of the cartridge is configured to fit over the central channel 604 a of the staple tray 604, and the staple holder 610 is configured to cover the clamping surface 106 of the staple tray 604. Additional features of staple cartridge 600, such as blade 51, are described below in connection with FIG. 3 (g), but these features are described in the operational state of surgical device 11.

  FIG. 3H is a bottom view of the first jaw portion 50. The first jaw 50 includes an anvil member 700 having a longitudinally disposed slot 701 that extends from the distal end to the proximal end of the anvil member 700. The slot 701 is second such that when the blade is moved from the distal end 80a to the proximal end 80b of the second jaw 80, the blade 51 extends into and moves along the slot 701. Align with the blade 51 of the jaw portion 80 of the chin portion. The anvil member 700 also includes a plurality of rows 702 of staple guides 703. The staple guide 703 is configured to receive the prong 606b of the staple 606 and bend the prong 606b to close the staple 606. When the surgical device 11 is in the closed position, the row 702 of staple guides 703 is aligned with the slots 604 h of the staple tray 604 of the second jaw 80.

  In operation, the jaw portion 11a is maintained in the initial position, where it is axially aligned with the shaft portion 11b, such as at the position shown in FIG. In this position, the surgical device 11 can be inserted into the surgical site, for example through a trocar. Depending on the location of the incision and tissue to be tightened, stapled, and cut, the user can articulate the jaw portion 11a relative to the shaft portion 11b.

  In the first articulation process, the jaw portion 11a is pivoted relative to the shaft portion 11b. Plate 518 is positioned in a first position, for example, such that the two openings in plate 518 are engaged and secured with teeth 516 of gear element 514 and teeth 5661 of gear element 562b, respectively. The first rotatable drive shaft 500 and the second rotatable drive shaft 550 are then rotated in opposite directions. For example, referring to FIG. 3 (b), the first rotatable drive shaft 500 is rotated counterclockwise to articulate the jaw portion 11a with respect to the shaft portion 11b (viewed from above) in a clockwise direction. (For simplicity, all references herein to a rotational direction such as clockwise or counterclockwise, for example, refer to the surgical device 11 from the proximal end of the surgical device unless otherwise indicated. (Refers to the field of view towards the distal end). Thus, the gear element 502 attached to the first rotatable drive shaft 500 likewise rotates in the counterclockwise direction. By engaging the gear element 504, the counterclockwise rotation of the gear element 502 rotates the gear element 504 around the pin 505 (as viewed from above) in a counterclockwise direction. By engaging the gear element 506, counterclockwise rotation of the gear element 504 causes the gear element 506 to rotate clockwise.

  At the same time, the second rotatable drive shaft 550 can rotate clockwise. Accordingly, the gear element 552 attached to the second rotatable drive shaft 550 likewise rotates in the clockwise direction. By engaging the gear element 554, clockwise rotation of the gear element 552 causes the gear element 554 to rotate counterclockwise around the pin 505 (viewed from above). By engaging the gear element 556, clockwise rotation of the gear element 554 causes the gear element 556 to rotate counterclockwise. The engagement of the plate 518 with the teeth 516 and 5661 prevents the gear elements 506 and 566 from rotating relative to the surgical device 11. Accordingly, the chin portion 11a rotates in the clockwise direction with respect to the shaft portion 11b (viewed from above). In order to rotate the jaw portion 11a in the opposite direction, for example, counterclockwise relative to the shaft portion 11b when viewed from above, the direction of rotation of the first and second rotatable drive shafts 500, 550 is reversed. The

  After the jaw portion 11a has rotated about the pin 505 to a desired position, the jaw portion is a second articulating process relative to the shaft portion 11b, for example, about the longitudinal axis of the jaw portion 11a, shown as axis D 11a can also be rotated. Plate 518 is maintained in a first position such that the two openings in plate 518 are engaged and secured with teeth 516 of gear element 514 and teeth 5661 of gear element 562b, respectively. Then, the first rotatable drive shaft 500 and the second rotatable drive shaft 550 rotate in the same direction. For example, referring to FIG. 3 (b), the first rotatable drive shaft 500 is counterclockwise to rotate the jaw portion 11a counterclockwise about its longitudinal axis relative to the shaft portion 11b. Can rotate in the direction of rotation. Thus, the gear element 502 attached to the first rotatable drive shaft 500 also rotates counterclockwise. By engaging the gear element 504, the counterclockwise rotation of the gear element 502 rotates the gear element 504 around the pin 505 (as viewed from above) in a counterclockwise direction. By engaging the gear element 506, counterclockwise rotation of the gear element 504 causes the gear element 506 to rotate clockwise. Since gear element 506 is attached to gear element 510 by shaft 508, clockwise rotation of gear element 506 causes gear element 510 to also rotate in the clockwise direction. By engaging the gear element 512, clockwise rotation of the gear element 510 causes the gear element 512 to rotate counterclockwise.

  The second rotatable drive shaft 550 can also rotate counterclockwise. Accordingly, the gear element 552 attached to the second rotatable drive shaft 550 rotates in the counterclockwise direction. By engaging the gear element 554, counterclockwise rotation of the gear element 552 causes the gear element 554 to rotate clockwise about the pin 505 (viewed from above). By engaging the gear element 556, clockwise rotation of the gear element 554 causes the gear element 556 to rotate in the clockwise direction. Since gear element 556 is attached to gear element 560 by shaft 558, clockwise rotation of gear element 556 causes gear element 560 to also rotate in the clockwise direction. By engaging gear element 562a, clockwise rotation of gear element 560 causes gear element 562a to rotate in a counterclockwise direction. Also, since both gear element 562a and gear element 562b are keyed to pin 513, for example, so that they cannot be rotated, rotation of gear element 562a in the counterclockwise direction causes gear element 562b to rotate. Rotate counterclockwise as well.

  Thus, gear element 562b and gear element 512 rotate together counterclockwise around their common longitudinal axis, such as the central axis of pin 513, for example. Since the plate 518 is maintained in the first position, the two openings in the plate 518 are engaged and secured with the teeth 516 of the gear element 514 and the teeth 5661 of the gear element 562b, respectively. Thus, counterclockwise rotation of gear element 562b and gear element 512 around pin 513 causes gear element 514 and gear element 564 to rotate counterclockwise around pin 513, with its center axis being a jaw. It is coaxial with the longitudinal axis D of the part 11a. A gear element is coupled to the screw 520 and a push block 522 is mounted thereon. Since the push block 522 is keyed to the inner surface of the jaw portion 11a, the rotation of the gear element 514 about the longitudinal axis D causes the jaw portion 11a to move about its longitudinal axis D relative to the shaft portion 11b. Rotate.

  After the jaw portion 11a has rotated to a desired position about its longitudinal axis D relative to the shaft portion 11b, the jaw portions 50, 80 can be opened to allow the tissue portion to be placed therebetween. To perform this operation, the plate 518 is moved away from its second position so that the two openings in the plate 518 are not engaged and locked with the teeth 516 of the gear element 514 and the teeth 5661 of the gear element 562b, respectively. Moved to the place. Then, the first rotatable drive shaft 500 rotates in the first direction, and the second rotatable drive shaft 550 does not rotate. For example, referring to FIG. 3B, the first rotatable drive shaft 500 can be rotated counterclockwise to open the first jaw 50 to the second jaw 80. Thus, the gear element 502 attached to the first rotatable drive shaft 500 also rotates counterclockwise. By engaging the gear element 504, the counterclockwise rotation of the gear element 502 rotates the gear element 504 around the pin 505 (as viewed from above) in a counterclockwise direction. By engaging the gear element 506, counterclockwise rotation of the gear element 504 causes the gear element 506 to rotate clockwise. Since gear element 506 is attached to gear element 510 by shaft 508, clockwise rotation of gear element 506 causes gear element 510 to also rotate clockwise. By engaging the gear element 512, clockwise rotation of the gear element 510 causes the gear element 512 to rotate counterclockwise. By engaging the gear element 514, counterclockwise rotation of the gear element 512 causes the gear element 514 to rotate in the clockwise direction. As the plate 518 is moved to the second position, the pin 513 does not rotate and the gear element 512 rotates about the pin 513.

  The clockwise rotation of the gear element 514 causes the threaded screw 520 to rotate in the clockwise direction. In the first stage of operation, for example, when the surgical device 11 is first inserted into the patient's body, the push block 522 is placed in the most distal position along the threaded screw 520. Rotation of the threaded screw 520 moves the push block 522 in the proximal direction, eg, keyed and non-rotatably mounted, within the inner surface of the surgical device 11. . Proximal movement of the push block 522 causes the pair of rollers 524 to move proximally within their respective slots 5011 on each side of the upper jaw 50. When the push block 522 moves to the proximal end of the threaded screw 520, the roller 524 is located at the proximal end of the slot 5011 where the first jaw 50 is the second jaw. The portion 80 is opened to the maximum.

  After the first and second jaw portions 50, 80 are opened to the desired position relative to each other, the jaw portions 50, 80 are closed to tighten the portion of tissue therebetween. Again, with the plate 518 in its second position, for example, the two openings in the plate 518 are not engaged and secured with the teeth 516 of the gear element 514 and the teeth 5661 of the gear element 562b, respectively. The first rotatable drive shaft 500 rotates in the second direction and the second rotatable drive shaft 550 does not rotate. For example, referring to FIG. 3 (b), the first rotatable drive shaft 500 can be rotated in a clockwise direction to close the first jaw 50 with respect to the second jaw 80. Thus, the gear element 502 attached to the first rotatable drive shaft 500 also rotates clockwise. By engaging the gear element 504, clockwise rotation of the gear element 502 causes the gear element 504 to rotate clockwise about the pin 505 (viewed from above). By engaging the gear element 506, clockwise rotation of the gear element 504 causes the gear element 506 to rotate counterclockwise. Since the gear element 506 is attached to the gear element 510 by the shaft 508, the counterclockwise rotation of the gear element 506 causes the gear element 510 to also rotate counterclockwise. By engaging the gear element 512, counterclockwise rotation of the gear element 510 causes the gear element 512 to rotate clockwise. By engaging the gear element 514, clockwise rotation of the gear element 512 causes the gear element 514 to rotate counterclockwise. As plate 518 is moved to its second position, pin 513 does not rotate and gear element 512 rotates about pin 513.

  Counterclockwise rotation of the gear element 514 causes the threaded screw 520 to rotate counterclockwise. As specified above, the push block 522 can be placed in the most proximal position along the threaded screw 520. The rotation of the threaded screw 520 moves the push block 522 keyed in the inner surface of the surgical device 11 in the distal direction. Distal movement of the push block 522 causes the pair of rollers 524 to move distally within their respective slots 5011 on each side of the upper jaw 50. As the push block 522 moves to the distal end of the threaded screw 520, the roller 524 is positioned at the distal end of the slot 5011 where the first jaw 50 is the second jaw. Tightened to 80 maximum. The first and second jaw portions 50, 80 can be opened and closed in a simple scissor style, but in other embodiments the first and second jaw portions 50, 80 can be opened and closed in different manners. Please keep in mind. An example of such a type of movement is described in further detail below in connection with FIGS. 3 (f) to 3 (i).

  After the tissue portion is clamped between the first jaw portion 50 and the second jaw portion 80, the tissue portion can be cut and stapled. Although the present invention is shown as using both cutting and stapling elements, the surgical device 11 can use only one such element or use a different type of surgical instrument. Please understand that you can. A staple cartridge 578 is provided in the second jaw 80 before the surgical device 11 is inserted into the patient's body. In one embodiment, the surgical device 11 is a disposable device in which the staple cartridge is integral with the second jaw 80. Alternatively, the surgical device 11 can have a replaceable staple cartridge, such as a replaceable staple cartridge 600, as shown in FIG. 3 (f), whereby the surgical device 11 uses a different staple cartridge. Can be used over and over again. In this embodiment, when the surgical device 11 is used for the first time, the staple cartridge 600 can be pre-mounted during manufacture and assembly of the surgical device 11 or can be mounted by the user immediately prior to using the surgical device 11. If the surgical device 11 is used a second time or more, the staple cartridge 600 can be worn by the user immediately before using the surgical device 11. When the staple cartridge 600 is inserted into the second jaw 80, the distal end 574 of the longitudinal rod 568 is received in the opening 605 d that faces the wedge drive 605 proximally.

  In order to show the cutting / stapling operation of the surgical device 11, reference is first made to FIG. The staple cartridge 600 is mounted in the second jaw 80 of the surgical device 11 so that the two openings of the plate 518 are not engaged and fixed with the teeth 516 of the gear element 514 and the teeth 5661 of the gear element 562b, respectively. In the meantime, the plate 518 is maintained in its second position. Then, the second rotatable drive shaft 550 rotates in the first direction, and the first rotatable drive shaft 500 does not rotate. For example, the second rotatable drive shaft 550 can be rotated in a counterclockwise direction to cut and staple the portion of tissue disposed between the first jaw 50 and the second jaw 80. . Accordingly, the gear element 552 attached to the second rotatable drive shaft 550 rotates in the counterclockwise direction. By engaging the gear element 554, counterclockwise rotation of the gear element 552 causes the gear element 554 to rotate clockwise about the pin 505 (viewed from above). By engaging the gear element 556, clockwise rotation of the gear element 554 causes the gear element 556 to rotate in the clockwise direction. Since gear element 556 is attached to gear element 560 by shaft 558, clockwise rotation of gear element 556 causes gear element 560 to also rotate in the clockwise direction. By engaging gear element 562a, clockwise rotation of gear element 560 causes gear elements 562a and 562b to rotate counterclockwise. By engaging the gear element 564, the counterclockwise rotation of the gear element 562b causes the gear element 564 to rotate in the counterclockwise direction. As plate 518 is moved to its second position, gear element 514 does not rotate and gear element 562b rotates with pin 513.

  The clockwise rotation of the gear element 564 causes the first longitudinal rod 566 to rotate with the second longitudinal rod 568 in the clockwise direction. A spring 570 between the distal end of the first longitudinal rod 566 and the shoulder 572 of the second longitudinal rod 568 will bias the second longitudinal rod 568 in the distal direction. To ensure that the distal end 574 of the second longitudinal rod 568 is seated within the respective opening 605d of the wedge drive 605.

  To further illustrate the cutting / stapling operation of the surgical device 11, reference is now made to FIG. FIG. 3 (g) is a cross-sectional view of the surgical device 11 in a fully closed position according to one embodiment of the present invention. In FIG. 3 (g), the surgical device 11 is shown with no tissue portion between the clamping surfaces 106, 108 of the first jaw 50 and the second jaw 80.

  As shown in FIG. 3 (g), the surgical device 11 is disposed in the second jaw 80, and the cutting and stapling element 104 is replaceably mounted in the second jaw 80. The replaceable staple cartridge 600 of g) is provided. The replaceable staple cartridge 600 shown in exploded view in FIG. 3 (f) is shown assembled and installed in the second jaw 80 in FIG. 3 (g).

  As shown in FIG. 3 (g), a wedge 603 places a blade 51 having a cutting edge 51a therein. Alternatively, the cutting and stapling elements can be placed separately. In the exemplary embodiment shown in FIG. 3 (g), the blade 51 has a tail region 654 with a contact surface 653. The blade 51 is rotatably coupled to the wedge 603 around the pivot 51b to allow it to rotate between the first and second positions. FIG. 3 (g) shows the wedge 603 at several positions, denoted as positions A through E, as the wedge 603 and blade 51 move from the distal end 604c to the proximal end 604d of the staple tray 604. And the blade 51 are shown.

  In the position labeled A, the wedge 603 and blade 51 are located at the distal end 604c of the staple tray 604. In the position labeled A, the wedge 603 and the blade 51 are housed in the housing 615, and the blade 51 is in a retracted position such that the cutting edge 51a faces upward and is not exposed, for example. Rotate against. Contact surface 653 initially faces proximal end 604d of staple tray 604.

  In operation, rotation of the wedge drive 605 via the distal end 574 of the second longitudinal rod 568 advances the wedge 603 and blade 51 to the position labeled B. In the position labeled B, wedge 603 and blade 51 are positioned proximal to distal end 604c of staple tray 604. In particular, at the position labeled B, the wedge 603 and blade 51 are positioned such that the contact surface 653 of the blade 51 begins to contact the actuation lip 615a of the housing 615. When the contact surface 653 of the blade 51 begins to contact the working lip 615a of the housing 615, the blade 51 begins to rotate relative to the wedge 603.

  Further rotation of the wedge drive 605 via the distal end 574 of the second longitudinal rod 568 advances the wedge 603 and blade 51 to the position labeled C. In the position labeled C, wedge 603 and blade 51 are positioned further proximal to the distal end 604c of staple tray 604. In particular, in the position labeled C, wedge 603 and blade 51 are positioned such that contact surface 653 of blade 51 is in full contact with actuation lip 615a of housing 615. When the contact surface 653 of the blade 51 comes into full contact with the working lip 615a of the housing 615, the blade 51 is cut, for example, by the cutting edge 51a of the blade 51, with the cutting edge 51a facing the proximal end 604d of the staple tray 604. Fully rotates relative to the wedge 603 so that is in an extended position.

  Further rotation of the wedge drive 605 via the distal end 574 of the second longitudinal rod 568 advances the wedge 603 and blade 51 to the position labeled D. In the position labeled D, the wedge 603 and blade 51 are positioned approximately midway between the distal end 604c and the proximal end 604d of the staple tray 604. In the position labeled D, the blade 51 is positioned at the proximal end of the staple tray 604 to cut the portion of tissue (not shown) clamped between the first jaw 50 and the second jaw 80. It is maintained in an extended position having a cutting edge 51a facing the portion 604d.

  Further rotation of the wedge drive 605 via the distal end 574 of the second longitudinal rod 568 advances the wedge 603 and blade 51 to the position labeled E. In the position labeled E, the wedge 603 and blade 51 are located at the proximal end 604d of the staple tray 604. In the position labeled E, the blade 51 remains in the extended position, with the cutting edge 51a facing the proximal end 604d of the staple tray 604. However, the blade 51 is housed in the housing 616 so that the cutting edge 51a is not exposed here.

  The staples 606 housed in the staple tray 604 can be sent out simultaneously with the movement of the blade 51 from the proximal end 80b of the second jaw 80 to the distal end 80a. For example, rotation of the wedge drive 605 through the distal end 574 of the second longitudinal rod 568 causes the wedge 603 to move through the central channel 604e of the staple tray 604. As the wedge 603 moves through the central channel 604e from the distal end 604c of the staple tray 604 to the proximal end 604d, the pair of inclined edges 603b of the wedge 603 slides on the respective upper surface 607a of the staple pusher 607. Engageably, staple pusher finger 607c of staple pusher 607 is continuously pushed into slot 604h of staple tray 604, thus pushing staple 606 out of slot 604h. When the surgical device 11 is in the closed position, the staple 606 maintained in the slot 604h of the staple tray 604 is pushed into the corresponding staple guide 703 of the anvil member 700 by the staple pushing finger 607c of the staple pusher 607, and the guide 703. The rows 702 of staple guides 703 are aligned with the slots 604h of the staple tray 604 of the second jaw 80. The staple guide 703 receives the prongs 606b of the staples 606 when the surgical device 11 feeds and bends the prongs 606b to close the staples 606, thereby stapling a portion of tissue.

  According to various embodiments of the present invention, the blade 51 and wedge 603 may be proximal or distal to cut a portion of tissue disposed between the first jaw 50 and the second jaw 80. It should be understood that it can move in the direction of Further, in accordance with various embodiments of the present invention, blade 51 may be used to cut and / or staple the portion of tissue disposed between first jaw 50 and second jaw 80. It should be understood that and any mechanical arrangement configured to move the wedge 603 can be used.

  As specified above, the opening and closing of the first and second jaw portions 50, 80 can be done in a simple scissor-type manner, but in other embodiments the first and second jaw portions 50, 80 are provided. Note that can be opened and closed in different ways. An example of such a type of movement is generally described below in connection with FIGS. 3 (i) to 3 (l). Further details and benefits of this type of migration are described in US Pat. No. 6,057,009, filed Jun. 11, 2003, which is expressly incorporated herein by reference in its entirety. For clarity, the components of surgical device 11 located proximal to gear element 514 and gear element 564 are not shown. It should be understood that these gear elements 514, 564 can be driven by the combination of drive components shown in FIGS. 3 (a) to 3 (e), or by any other combination of drive components.

  FIG. 3 (i) shows the first jaw part 50 in an open position with respect to the second jaw part 80. In this position, the push block 522 is at or near the proximal end of the threaded screw 520 and the roller 524 attached to the push block 522 is in the slot 5011 of the first jaw 50. Located at or near the proximal end. The first jaw 50 includes a pivot pin 5012 that is engaged in a longitudinal slot 5013 of the second jaw 80. The proximal ends 50b, 80b of the first and second jaw portions 50, 80 are each such that the pin 5012 is located at the lower end of the slot 5013 in the initial position shown in FIG. , Biased away from each other.

  Referring to FIG. 3 (j), as gear element 514 rotates, push block 522 moves distally to the first intermediate position of threaded screw 520 and is similarly attached to push block 522. Rolled roller 524 is moved distally within slot 5011 of first jaw 50 to a first intermediate position. In the position shown in FIG. 3 (j), pin 5012 moves within slot 5013 until it is eventually placed at the upper end of slot 5013. In this way, the distal ends 50a, 80a of the first and second jaws 50, 80 are brought together before the first and second jaws 50, 80 are fully clamped together.

  Referring to FIG. 3 (k), as the gear element 514 rotates further, the push block 522 continues to move distally to the second intermediate position of the threaded screw 520, as well as the push block 522. The roller 524 attached to the chin continues to move distally within the slot 5011 of the first jaw 50 to a second intermediate position. In the position shown in FIG. 3 (k), further tightening of the first and second jaws 50 and 80 will again slot until the pin 5012 is eventually placed at the lower end of the slot 5013. Move within 5013. In this way, the distal ends 50a, 80a of the first and second jaw portions 50, 80 are joined together while the proximal portions of the first and second jaw portions 50, 80 are gradually tightened together. Will remain. Successive distal movement of push block 522 along threaded screw 520 eventually places surgical device 11 in the position shown in FIG. 3 (l), where the first and second The jaws 50, 80 are clamped together at their distal ends 50a, 80a and their proximal ends 50b, 80b.

  As specified above, these are a variety of different mechanisms that can be used to move the first jaw 50 relative to the second jaw 80. Regardless of the mechanism used for this purpose, it is generally desirable to use a mechanism that exerts a strong clamping force on the portion of tissue disposed between the first jaw 50 and the second jaw 80. FIG. 4 (a) is a perspective view of a surgical device 11 according to another embodiment of the present invention that uses a different mechanism to move the first jaw 50 relative to the second jaw 80. FIG.

  FIG. 4 (b) is a perspective view illustrating another feature of the second jaw portion 80 of the jaw portion 11a according to an exemplary embodiment of the present invention. For the sake of clarity, the first jaw 50 is shown in phantom. In particular, FIG. 4 (b) shows a portion of the first drive 88, such as a horizontal drive element 301 coupled to the first rotatable clamping element 302. These and other features of the first drive 88 according to this embodiment are further illustrated in FIGS. 5 (a) to 5 (d).

  FIG. 5A is a perspective view showing the proximal end portion 80 b of the second jaw portion 80. The proximal end 50b of the first jaw 50 is shown in phantom. FIG. 5 (a) shows the surgical device 11 in a fully open position. In this embodiment, the first drive unit 88 includes a rotating shaft 303. The first drive unit 88 also includes a horizontal drive element 301. The proximal end of the horizontal drive element 301 is engaged by the rotating shaft 303. The distal end of the horizontal drive element 301 is provided with an opening 3011. The first drive 88 also includes a first rotatable clamping element 302. The first rotatable clamping element 302 has a proximal end 3021, an intermediate portion 3022, and a distal end 3023.

  The first drive 88 also comprises a second rotatable clamping element 303. The second rotatable clamping element 303 has a proximal end 3032 and a distal end 3031. The proximal end of the first rotatable clamping element 302 is pivotally connected to the opening 3011 at the distal end of the horizontal drive element 301. The intermediate portion 3022 of the first rotatable clamping element 302 is pivotally connected to the proximal end 3032 of the second rotatable clamping element 303. The distal end 3021 of the first rotatable clamping element 302 is pivotally connected to the first jaw 50. The distal end 3031 of the second rotatable clamping element 303 is pivotally connected to the second jaw 50. Similarly, the proximal end 50b of the jaw 50 is pivotally connected to the proximal end 80b of the second jaw 80 about pivot point A.

  When the first drive portion FIG. 88 is engaged, the surgical device 11 is moved to a first partially closed position, as shown in FIG. 5 (b). In particular, when engaged with the first motor 96, the first drive shaft 94 rotates the first drive socket 654 in the first direction. The rotation of the first drive socket 654 rotates the rotating shaft 303 of the first drive 88, thereby moving the horizontal drive element 301 in the distal direction. The components of the first drive 88 are described in connection with this embodiment as comprising a rotating shaft 303, but as specified above, the embodiment shown in FIGS. 3 (a) to 3 (e). May comprise some or all of the components described in connection with or may comprise any other device of components suitable for moving the horizontal drive element 301 with a distal drive. Please understand that you can.

  Still referring to FIG. 5 (b), the distal movement of the horizontal drive element 301 is such that the distal end 3023 of the second rotatable clamping element 302 begins to move in a downward direction. One rotatable clamping element 302 is rotated. The downward movement of the distal end 3023 of the second rotatable clamping element 302 relative to the first jaw 50 by means of its pivotable attachment causes the first jaw 50 to move to the second jaw 80. Rotate to a partially closed position around pivot point A.

  As the first drive 88 further engages, the surgical device 11 is moved to the second partially closed position, as shown in FIG. 5 (c). In particular, when the first motor 96 is further engaged, the horizontal drive element 301 is moved through the rotation of the first drive shaft 94, the first drive socket 654, and the rotary shaft 303 of the first drive unit 88. And move it in a more distal direction. Subsequent distal movement of the horizontal drive element 301 causes the first rotatable clamping element such that the distal end 3023 of the second rotatable clamping element 302 continues to move in a downward direction. 302 is further rotated. Subsequent downward movement of the distal end 3023 of the second rotatable clamping element 302 relative to the first jaw 50 by its pivotable attachment device causes the first jaw 50 to move to the second The jaw part 80 is rotated to a position almost completely closed around the turning point A.

  When the first drive unit 88 is further engaged, the surgical device 11 is moved to the fully closed position as shown in FIG. In particular, when the first motor 96 is further engaged, the horizontal drive element 301 is moved through the rotation of the first drive shaft 94, the first drive socket 654, and the rotary shaft 303 of the first drive unit 88. To the maximum distal position. In the maximally distal position, the first rotatable clamping element 302 is maximized so that the distal end 3023 of the first rotatable clamping element 302 is in a maximally lowered position. Rotate. In the fully lowered position, the portion of the tissue 52 disposed between the first jaw 50 and the second jaw 80 is completely between the first jaw 50 and the second jaw 80. The distal end 3023 of the first rotatable clamping element 302 moves the first jaw 50 to a fully closed position about pivot point A so that it can be clamped.

  According to an exemplary embodiment of the invention, the surgical device 11 can be configured as an attachment to a purely mechanical device drive system, such as that shown in FIG. 1, or can be integral therewith. In another embodiment, the surgical device 11 can be configured as, or integral with, an attachment to an electromechanical surgical system such as the electromechanical drive system 1610 shown in FIG. 2 (a). .

  In particular, FIG. 2 (a) is a perspective view of an exemplary embodiment of an electromechanical drive component 1610 according to the present invention. Such an electromechanical surgical system is currently disclosed in US Pat. No. 6,793,652, filed Nov. 28, 2000, which is US Pat. No. 6,793,652, patented on Sep. 21, 2004. Patent Document 5, filed on May 17, Patent Document 4, filed June 22, 2001, Patent Document 13, filed March 15, 2002, each of which is expressly incorporated herein by reference in its entirety. Incorporated. The electromechanical drive component 1610 can comprise a remote power console 1612 comprising a housing 1614 having a front panel 1615, for example. A display device 1616 and indicators 1618a and 1618b are attached to the front panel 1615. A flexible shaft 1620 can extend from the housing 1614 and can be removably attached thereto via a first coupling 1622. The distal end 1624 of the flexible shaft 1620 has a second coupling 1626 that is adapted to removably couple the surgical device 11 described above to the distal end 1624 of the flexible shaft 1620, for example. Can be provided. The second coupling 1626 can also be adapted to removably attach different surgical instruments or accessory devices. In another exemplary embodiment, the distal end 1624 of the flexible shaft 1620 can be permanently attached to or integral with the surgical instrument.

  FIGS. 6 (a) through 6 (e) illustrate a coupling and flexible shaft arrangement that can be used to couple the surgical device 11 to an electromechanical drive component 1610, according to one embodiment of the present invention. Indicates. For example, FIG. 6 (a) shows a flexible shaft 2620 extending from the housing 1614 that is removably attached to the housing 1614 via a first coupling 2622. The distal end 2624 of the flexible shaft 2620 has a second coupling 2626 adapted to removably couple the surgical device 11 described above to the distal end 2624 of the flexible shaft 2620, for example. Can be provided. FIG. 6 (b) shows a rear perspective view of the first coupling 2622 according to one embodiment of the present invention. FIG. 6 (c) shows a front perspective view of the first coupling 2622 according to the embodiment shown in FIG. 6 (b). FIG. 6 (d) is a side perspective view of some internal components of the first coupling 2622. FIG. 6 (e) is a rear perspective view of the second coupling 2626 at the distal end 2624 of the flexible shaft 2620, according to one embodiment of the present invention. For clarity, the flexible shaft 2620 is shown as an imaginary line in FIG. 6 (e). Further features of these components are further described in US Pat.

  The combination of the flexible shaft 2620 and the couplings 2622, 2626 provides one arrangement whereby the surgical device 11 can be attached to the electromechanical power console 1610, but any suitable arrangement is used. be able to. For example, FIGS. 7-10 show another arrangement whereby the surgical device 11 can be attached to an electromechanical power console 1610. Referring to FIG. 7, a partially sectioned side view of the flexible shaft 1620 is shown. According to an exemplary embodiment, the flexible shaft 1620 includes a tubular sheath 1628 that has a coating or other sealing arrangement configured to form a fluid tight seal between its inner channel 1640 and the periphery. Can be provided. The sheath 1628 can be formed from a tissue compatible, sterile, elastomeric material. The sheath 1628 can also be formed from a material that can be autoclaved. First rotatable drive shaft 94, second rotatable drive shaft 102, first steering cable 1634, second steering cable 1635, third steering cable 1636, fourth steering cable 1637, and data A transfer cable 1638 is disposed within the inner channel 1640 of the flexible shaft 1620 and extends along its entire length. FIG. 8 is a cross-sectional view of the flexible shaft 1620 taken along line 8-8 shown in FIG. 7 and further shows some cables 94, 102, 1634, 1635, 1636, 1637, and 1638. Each distal end of the steering cables 1634, 1635, 1636, 1637 is secured to the distal end 1624 of the flexible shaft 1620. A number of each cable 94, 102, 1634, 1635, 1636, 1637, 1638 can be housed within a respective sheath.

  The first rotatable drive shaft 94 and the second rotatable drive shaft 102 can be configured as, for example, highly flexible drive shafts, such as, for example, a braided or helical drive cable. It should be understood that such highly flexible drive cables may have limited torque transmission characteristics and capabilities. It should also be understood that the surgical device 11 or other accessory device coupled to the flexible shaft 1620 may require a higher torque input than can be transmitted by the drive shafts 94, 102. Accordingly, the drive shafts 94, 102 can be configured to transmit high speed but low torque, such as the flexible drive shaft 1620 of the surgical instrument or accessory and / or the remote power console 1612, for example. It is converted to low speed / high torque by a gear arrangement located at the distal end and / or the proximal end. Such a gear mechanism is any suitable along a power train between a motor disposed in the housing 1614 and an attached surgical instrument or other accessory device coupled to the flexible shaft 1620. It should be understood that a position can be provided. Examples of such a gear mechanism include a spur gear mechanism, a planetary gear mechanism, a harmonic gear mechanism, a cycloid drive mechanism, and an epicyclic gear mechanism.

  Referring now to FIG. 9, a rear end view of the first coupling is shown. The first coupling 1622 includes a first connector 1644, a second connector 1648, a third connector 1652, and a fourth connector 1656, each of which is rotatably fixed to the first coupling 1622. . Each connector 1644, 1648, 1652, 1656 includes a respective recess 1646, 1650, 1654, 1658. As shown in FIG. 9, each indentation 1646, 1650, 1654, 1658 can be formed in a hexagon. However, the recesses 1646, 1650, 1654, 1658 were adapted to non-rotatably connect and securely attach the connectors 1644, 1648, 1652, 1656 to the respective drive shafts of the motor mechanism housed in the housing 1614. It should be understood that it can have any shape and configuration. It should be understood that complementary protrusions can be provided on each drive shaft of the motor mechanism, thereby driving the drive elements of the flexible shaft 1620. It should also be understood that a recess can be provided in the drive shaft and complementary protrusions can be provided in connectors 1644, 1648, 1652, 1656. Any other coupling mechanism configured to non-rotatably and releasably connect the connectors 1644, 1648, 1652, 1656 and the drive shaft of the motor mechanism may be provided.

  One of the connectors 1644, 1648, 1652, 1656 is non-rotatably secured to the first drive shaft 94 and another one of the connectors 1644, 1648, 1652, 1656 is non-rotatable to the second drive shaft 102 Fixed to. The remaining two of the connectors 1644, 1648, 1652, 1656 apply tension to the steering cables 1634, 1635, 1636, 1637, thereby steering the distal end 1624 of the flexible shaft 1620. Engaging a transmission element configured to Data transmission cable 1638 is electrically and logically connected to data connector 1660. Data connector 1660 includes, for example, the same number of electrical connectors 1662 that correspond to the number of individual wires housed in data cable 1638. The first coupling 1622 includes a key structure 1642 configured to properly direct the first coupling 1622 to an interlocking and complementary coupling mechanism disposed in the housing 1612. The key structure 1642 may be provided on either or both of the first coupling 1622 and the mating and complementary coupling mechanism disposed on the housing 1612. The first coupling 1622 can comprise a quick connect connector that allows the first coupling 1622 to engage the housing 1612 by a simple pushing action. A seal can be provided in conjunction with any of several connectors 1644, 1648, 1652, 1656, 1660 to form a fluid tight seal between the inside and the periphery of the first coupling 1622.

  Referring now to FIG. 10, a front end view of the second coupling 1626 of the flexible shaft 1620 is shown. In the illustrated embodiment, the second coupling 1626 includes a first connector 1666 and a second connector 1668, each rotatably fixed to the second coupling 1626, and each first and second drive. Non-rotatably secured to the distal end of each of the shafts 94,102. A quick connect fitting 1664 is provided on the second coupling 1626 to removably secure the device 11 thereto. The quick connection type fitting 1664 can be, for example, a rotary type quick connection type fitting, a bayonet type fitting, or the like, and can be a fitting that is complementary to the quick connection sleeve 713 shown in FIG. . A key structure 1674 can be provided on the second coupling 1626 and can be configured to properly align the surgical device 11 with the second coupling 1626. A key structure or other mechanism configured to properly align the surgical device 11 with the flexible shaft 1620 may be provided on either or both of the second coupling 1626 and the surgical device 11. it can. Furthermore, a key structure can be provided on the device 11 as shown in FIG. A data connector 1670 having an electrical contact 1672 is also provided on the second coupling 1626. Similar to the data connector 1660 of the first coupling 1622, the data connector 1670 of the second coupling 1626 is electrically and logically connected to the respective wires of the data transfer cable 1638 and the contacts 1662 of the data connector 1660. The contact portion 1672 is provided. Seals can be provided in connection with several connectors 1666, 1668, 1670 to form a fluid tight seal between the inside and periphery of the second coupling 1626.

  Drive shafts 94, 102 and steering cables 1634, 1635, 1636, 1637 in the housing 1614 of the remote power console 1612 are thereby attached to the electromechanical drive component 1610 and the second coupling 1626. An electromechanical drive element configured to operate the operated surgical device 11 is arranged. In the exemplary embodiment schematically illustrated in FIG. 11, five electric motors 96, 100, 1684, 1690, 1696, each operated via a power source, can be located on the remote power console 1612. However, it should be understood that any suitable number of motors can be provided and the motors can operate via battery power, line current, DC power, electronically controlled DC power, and the like. It should also be understood that the motor is coupled to a DC power supply, which is connected to line current, thereby supplying operating current to the motor.

  FIG. 11 schematically shows a possible arrangement of motors. The output shaft 1678 of the first motor 96 is engaged with the first connector 1644 of the first coupling 1622 when the first coupling 1622 and thus the flexible shaft 1620 engages the housing 1614. , Thereby driving the first drive shaft 94 and the first connector 1666 of the second coupling 1626. Similarly, the output shaft 1682 of the second motor 100 is connected to the second connector of the first coupling 1622 when the first coupling 1622 and thus the flexible shaft 1620 engages the housing 1614. 1648 engages thereby driving second drive shaft 102 and second connector 1668 of second coupling 1626. The output shaft 1686 of the third motor 1684 engages the third connector 1652 of the first coupling 1622 when the first coupling 1622 and thus the flexible shaft 1620 engages the housing 1614. Thereby driving the first and second steering cables 1634, 1635 through the first pulley mechanism 1688. The output shaft 1692 of the fourth motor 1690 engages the fourth connector 1656 of the first coupling 1622 when the first coupling 1622 and thus the flexible shaft 1620 engages the housing 1614. Thereby driving the third and fourth steering cables 1636, 1637 via the second pulley mechanism 1694. Third and fourth motors 1684, 1690 can be secured to cartridge 1100 for selectively engaging and disengaging third and fourth motors 1684, 1690 with respective pulley mechanisms 1688, 1694. Is selectively movable between the first position and the second position via the output shaft 1698 of the fifth motor 1696 so that the flexible shaft 1620 can be tightened and steered as required. To be able to relax or loosen. It should be understood that other mechanical, electrical, and / or electromechanical mechanisms can be used to selectively engage and disengage the steering mechanism. The motor can be arranged and configured as described, for example, in US Pat. No. 6,069,097, entitled “A Carriage Assembly for Controlling a Steering Wire Mechanism Within a Flexible Shaft”, the application of which is expressly incorporated herein by reference in its entirety. Incorporated. According to other embodiments of the present invention, there is no possibility of any steering mechanism and the surgical device 11 is articulated between the jaw portion 11a and the shaft portion 11b so as to operate the surgical device 11 within the surgical site. It should also be understood that this results in movement.

  Any one or more of the motors 96, 100, 1684, 1690, 1696 can be, for example, a high speed / low torque motor, a low speed / high torque motor, and the like. As indicated above, the first rotatable drive shaft 94 and the second rotatable drive shaft 102 can be configured to transmit high speed and low torque. Therefore, the first motor 96 and the second motor 100 can be configured as high speed / low torque motors. Alternatively, the first motor 96 and the second motor 100 are the same as the first motor 96 and the second motor 100, respectively, the first rotatable drive shaft 94 and the second rotatable drive shaft 102. The motor can be configured as a low-speed / high-torque motor equipped with a gear mechanism for decreasing torque / increasing speed. Such a torque reduction / speed increase gear mechanism can include, for example, a spur gear mechanism, a planetary gear mechanism, a harmonic gear mechanism, a cycloid drive mechanism, and an epicyclic gear mechanism. It should be understood that any such gear mechanism can be located, for example, in the remote power console 1612 or at the proximal end of a flexible shaft 1620, such as the first coupling 1622, for example. One or more gear mechanisms are provided at the distal and / or proximal ends of the first rotatable drive shaft 94 and / or the second rotatable drive shaft 102 to prevent winding and breakage thereof. Please understand that it prevents.

  Referring now to FIG. 12, a schematic diagram of an electromechanical drive component 1610 is shown. A controller 1122 is provided in the housing 1614 of the remote power console 1612 and is attached to the electromechanical drive component 1610 and the linear clamping, cutting, stapling device 11 or flexible shaft 1620. It is configured to control all functions and operations of other surgical instruments or accessory devices. A memory unit 1130 is provided and may comprise memory devices such as ROM component 1132, RAM component 1134. ROM component 1132 is electrically and logically connected to controller 1122 via line 1136, and RAM component 1134 is electrically and logically connected to controller 1122 via line 1138. The RAM component 1134 may comprise any type of random access memory, such as a magnetic storage device, an optical storage device, a magneto-optical storage device, an electronic storage device, and the like. Similarly, ROM component 1132 can include any type of read-only memory, such as a removable storage device such as a PC card or PCMCIA type device. ROM component 1132 and RAM component 1134 can be configured as a single unit, or can be separate units, and ROM component 1132 and / or RAM component 1134 can be PC card or PCMCIA type devices. It should be understood that it can be provided in the form of

  The controller 1122 is further coupled to the front panel 1615 of the housing 1614, and more specifically to the display device 1616 via line 1154 and to the indicators 1618a, 1618b via respective lines 1156, 1158. The Lines 1116, 1118, 1124, 1126, 1128 electrically and logically connect the controller 1122 to the first, second, third, fourth, and fifth motors 96, 100, 1684, 1690, 1696, respectively. To do. A wired remote control unit (“RCU”) 1150 is electrically and logically connected to controller 1122 via line 1152. A wireless RCU 1148 is also provided and communicates via a wireless link 1160 with a receive / transmit unit 1146 coupled to transceiver 1140 via line 1144. Transceiver 1140 is electrically and logically coupled to controller 1122 via line 1142. The wireless link 1160 can be, for example, an optical link such as an infrared link, a radio link, or any other form of wireless communication link.

  For example, a switch device 1186, which can comprise an array of DIP switches, can be connected to the controller 1122 via line 1188. The switch device 1186 can be configured to select one of a plurality of languages used to display messages and guidance on the display device 1616, for example. The messages and guidance can relate to, for example, the operation and / or status of the electromechanical drive component 1610 and / or the surgical device 11 attached thereto.

  According to an exemplary embodiment of the present invention, a first encoder 1106 is provided in the second coupling 1626 and is responsive to the rotation of the first drive shaft 94 to output a signal due to that rotation. Composed. A second encoder 1108 is similarly provided in the second coupling 626 and is configured to output a signal due to the rotation in response to the rotation of the second drive shaft 102. The output of the signal of each encoder 1106, 1108 can represent the position of rotation of each drive shaft 94, 102 and its direction of rotation. These encoders can be an array of light sources such as LEDs and optical fibers, for example as shown in FIG. 6 (e). Alternatively, such encoders 1106, 1108 can include, for example, Hall effect devices, optical devices, and the like. Although encoders 1106, 1108 are described as being disposed within second coupling 1626, it should be understood that encoders 1106, 1108 can be provided at any location between the motor system and surgical device 11. . It should be understood that by providing an encoder 1106, 1108 in the second coupling 1626 or at the distal end of the flexible shaft 1620, the rotation of the drive shaft can be accurately determined. If the encoders 1106, 1108 are located at the proximal end of the flexible shaft 1620, the winding of the first and second rotatable drive shafts 94, 102 may introduce measurement errors.

  FIG. 13 is a schematic diagram of encoders 1106, 1108 comprising Hall effect devices. A magnet 1240 having an N pole 1242 and an S pole 1244 is non-rotatably attached to the drive shafts 94 and 102. The encoders 1106, 1108 further comprise a first sensor 1246 and a second sensor 1248 disposed about 90 ° apart from the longitudinal or rotational axis of the drive shafts 94, 102. The outputs of the sensors 1246 and 1248 are permanent and change their states according to changes in the polarity of the magnetic field in the detection range of the sensors. Therefore, based on the output signals from the encoders 1106 and 1108, the angular positions of the drive shafts 94 and 102 can be determined within a quarter rotation, and the rotation direction of the drive shafts 94 and 102 can be determined. The output of each encoder 1106, 1108 is transmitted to the controller 1122 via the respective line 1110, 1112 of the data transfer cable 1638. The controller 1122 configures the surgical device coupled to the electromechanical drive component 1610 by tracking the angular position and direction of rotation of the drive shafts 94, 102 based on output signals from the encoders 1106, 1108. The position and / or state of the element can be determined. That is, by counting the rotation of the drive shafts 94, 102, the controller 1122 can determine the position and / or status of the components of the surgical device coupled to the electromechanical drive component 1610.

  For example, the advance distance of the first jaw 50 and the wedge 603 relative to the second jaw 80 depends on the rotation of the drive shafts 94 and 102 and can be confirmed based on the rotation. it can. By checking the absolute position of the first jaw 50 and wedge 603 at some point, the output signals from the encoders 1106 and 1108 and the known pitch of the threaded screw 520 and wedge drive 605 are obtained. Based on the relative displacement of the first jaw portion 50 and the wedge 603 based on the absolute position of the first jaw portion 50 and the wedge 603 at all the subsequent time points can be confirmed. The absolute position of the first jaw 50 and wedge 603 can be determined and confirmed when the surgical device 11 is first coupled to the flexible shaft 1620. Alternatively, for example, the positions of the first jaw 50 and the wedge 603 with respect to the second jaw 80 can be determined based on output signals from the encoders 1106 and 1108.

  As discussed above in connection with FIGS. 2 (b) and 10, the surgical device 11 is configured to electrically and logically connect by size and configuration to the connector 1670 of the second coupling 1626. A connector 1272 may be provided. In the exemplary embodiment, data connector 1272 includes a number of contacts 1276 equal to the number of contacts 1672 of connector 1670. The memory module 6041 is electrically and logically coupled to the data connector 1272. The memory module 6041 can be in the form of, for example, EEPROM, EPROM, etc., for example, as shown in FIG. 3 (f), the staple cartridge 600 of the staple cartridge 600 that can be replaced by the second jaw portion 80 of the surgical device 11. It can be stored in the staple tray 604.

  FIG. 14 schematically shows the memory module 6041. As can be seen in FIG. 14, the data connector 1272 includes contacts 1276 that are each electrically and logically connected to the memory module 6041 via respective lines, such as a flexible data cable 1278. The memory module 6041 can be configured to store, for example, serial number data 1180, accessory device type identifier (ID) data 1182, usage status data 1184, and the like. The memory module 6041 can further store other data. Both serial number data 1180 and ID data 1182 can be configured as read-only data. Serial number data 1180 and / or ID data 1182 can be stored in a read-only section of memory module 6041. In the illustrated embodiment, serial number data 1180 can be data that uniquely identifies a particular surgical device, while ID data 1182 can be attached, for example, by other types of surgical instruments or accessories. The data may identify the type of accessory device, such as for electromechanical drive component 1610. The usage status data 1184 represents the usage status of a specific accessory device, such as the number of times the first jaw 50 of the surgical device 11 has been opened or closed, or the number of times the wedge 603 of the surgical device 11 has advanced. Usage data 1184 can be stored in a read / write area of memory module 6041.

  It should be understood that an attachment that can be attached to the distal end 1624 of the flexible shaft 1620, such as the surgical device 11, for example, can be designed and configured to be used once or multiple times. The accessory device can also be designed and configured to be used a predetermined number of times. Accordingly, the usage status data 1184 can be used to determine whether the surgical device 11 has been used and whether the number of uses has exceeded the maximum available number. As will be more fully described below, an ERROR condition occurs when an attempt is made to use an attached device after the maximum usable count has been reached.

  Referring again to FIG. 12, the controller 1122 is configured to read the ID data 1182 from the memory module 6041 of the surgical device 11 when the surgical device 11 is first connected to the flexible shaft 1620. Memory module 6041 is electrically and logically connected to controller 1122 via line 1120 of data transfer cable 1638. Based on the read ID data 1182, the controller 1122 is configured to read or select an operating program or algorithm corresponding to the type of surgical instrument or accessory device coupled to the flexible shaft 1620 from the memory unit 1130. . The memory unit 1130 is configured to store an operating program or algorithm for each type of surgical instrument or accessory device available, and the controller 1122 is read from the memory module 6041 of the attached surgical instrument or accessory device. The operating program or algorithm is selected and / or read from the memory unit 1130 according to the ID data 1182. As indicated above, the memory unit 1130 can comprise a removable ROM component 1132 and / or a RAM component 1134. Accordingly, the operating program or algorithm stored in the memory unit 1130 can be updated, added, deleted, improved, or revised as needed. The operating program or algorithm stored in the memory unit 1130 can be customizable based on, for example, user specific requirements. For example, a data input device such as a keyboard, mouse, pointing device, touch screen, etc. may be connected to the memory unit 1130 via, for example, a data connector port, for example, to facilitate customization of an operating program or algorithm. Alternatively or additionally, the operating program or algorithm can be customized and pre-programmed into the memory unit 1130 remotely from the electromechanical drive component 1610. It should be understood that the serial number data 1180 and / or usage data 1184 can also be used to determine which of a plurality of operating programs or algorithms are read or selected from the memory unit 1130. . Instead, it should be understood that the operating program or algorithm can be stored in the memory module 6041 of the surgical device 11 and transferred to the controller 1122 via the data transfer cable 1638. After the appropriate operating program or algorithm is read or selected by controller 1122 or communicated to controller 1122, controller 1122 may perform operations performed by the user via wired RCU 1150 and / or wireless RCU 1148. Causes an operating program or algorithm to be executed. As indicated above, controller 1122 includes first, second, third, fourth, and fifth motors 96, 100, 1684, 1690, 1696 and respective lines 1116, 1118, 1124, 1126, 1128. Are electrically and logically connected to each other, and such motors 96, 100, 1684, 1690, 1696 are read, selected, or transmitted via respective lines 1116, 1118, 1124, 1126, 1128. Configured to be controlled according to an operating program or algorithm.

  Referring now to FIG. 15, a schematic diagram of a wireless RCU 1148 is shown. The wireless RCU 1148 includes a steering control device 1300 having a plurality of switches 1302, 1304, 1306, 1308 disposed under the four-way rocker 1310. The operation of the switches 1302, 1304 via the rocker 1310 controls the operation of the first and second steering cables 1634, 1635 via the third motor 1684. Similarly, the operation of switches 1306, 1308 through rocker 1310 controls the operation of third and fourth steering cables 1636, 1637 through fourth motor 1692. The rocker 1310 and the switches 1302, 1304, 1306, 1308 steer the flexible shaft 1620 in the north-south direction with the operation of the switches 1302, 1304, and the operation of the switches 1306, 1308 in the east-west direction. It should be understood that they are arranged to steer. References herein to north, south, east, and west are made with respect to the coordinate system. Alternatively, a digital joystick, an analog joystick, or the like can be provided instead of the rocker 1310 and the switches 1302, 1304, 1306, 1308. A potentiometer or any other type of actuator may be used in place of the switches 1302, 1304, 1306, 1308.

  The wireless RCU 1148 further includes a steering engagement / disengagement switch 1312. By operating this, the operation of the fifth motor 696 is controlled to selectively engage and disengage the steering mechanism. The wireless RCU 1148 also includes a two-way locker 1314 that has first and second switches 1316, 1318 operable thereby. The operation of these switches 1316, 1318 is for surgical instruments such as surgical device 11 attached to electromechanical drive component 1610 and flexible shaft 1620 in accordance with an operating program or algorithm corresponding to the attached device. Or control some functions of attached devices. For example, by operating the two-way locker 1314, opening and closing of the first jaw part 50 and the second jaw part 80 of the surgical device 11 can be controlled. The wireless RCU 1148 is provided with a separate switch 1320 that operates further according to the operating program or algorithm corresponding to the attached device and the operation of the device attached to the electromechanical drive component 1620 and the flexible shaft 1620. Can be controlled. For example, by operating the switch 1320, advancement of the wedge 603 of the surgical device 11 can be started.

  Wireless RCU 1148 includes a controller 1322, which is electrically and logically connected to switches 1302, 1304, 1306, 1308 via line 1324, switches 1316, 1318 via line 1326, and switch 1312 is a line. The switch 1320 is connected via 1330 via 1328. The wireless RCU 1148 may comprise displays 1618a ', 1618b' corresponding to the displays 1618a, 1618b of the front panel 1615, and a display device 1616 'corresponding to the display device 1616 of the front panel 1615. As a premise, the indicators 1618a ′, 1618b ′ are electrically and logically connected to the controller 1322 via respective lines 1332, 1334, and the display device 1616 ′ is electrically and logically connected to the controller 1322 via lines 1336. Logically connected. Controller 1322 is electrically and logically connected to transceiver 1338 via line 1340, and transceiver 1338 is electrically and logically connected to receiver / transmitter 1342 via line 1344. A power source, such as a battery, can be provided in the wireless RCU 1148 to supply power thereto. Accordingly, the wireless RCU 1148 can be used to control the operation of the device 11 attached to the electromechanical drive component 1610 and the flexible shaft 1620 via the wireless link 1160.

  The wireless RCU 1148 can include a switch 1346 connected to the controller 1322 via line 1348. By manipulating switch 1346, the data signal is communicated to transmitter / receiver 1146 via wireless link 1160. The data signal includes identification data that uniquely identifies the wireless RCU 1148. This identification data is used by the controller 1122 to prevent unauthorized manipulation of the electromechanical drive component 1610 and to prevent interference with the operation of the electromechanical drive component 1610 by another wireless RCU. The Each subsequent communication of the wireless RCU 1148 and the electromechanical surgical device 1610 may include identification data. Thus, the controller 1122 can distinguish between multiple wireless RCUs, whereby only a single identifiable wireless RCU 1148 is attached to the electromechanical drive component 1610 and the flexible shaft 1620. It becomes possible to control the operation of the surgical device 11.

  Based on the position of the components of the surgical device attached to the flexible shaft 1620 determined according to the output signals from the encoders 1106, 1108, the controller 1122 is defined by the operating program or algorithm corresponding to the attached device. The function of the electromechanical drive component 1610 to be performed can be selectively enabled or disabled. For example, for the surgical device 11, the delivery function controlled by operating the switch 1320 is determined such that the space or gap between the first jaw 50 and the second jaw 80 is within an acceptable range. It can be disabled without anything.

  Referring now to FIG. 16, a schematic diagram of a wired RCU 1150 is shown. In the exemplary embodiment, wired RCU 1150 comprises substantially the same control elements as wireless RCU 1148, and further description of such elements is omitted. Similar elements are shown in FIG. 16 with the main ones. It should be understood that the function of the electromechanical drive component 1610 and the device attached to the flexible shaft 1620 such as the surgical device 11 can be controlled by the wired RCU 1150 and / or the wireless RCU 1148. For example, in the event of a battery failure at the wireless RCU 1148, the wired RCU 1150 can be used to control the function of the devices attached to the electromechanical drive component 1610 and the flexible shaft 1620.

  As mentioned above, the front panel 1615 of the housing 1614 includes a display device 1616 and indicators 1618a, 1618b. Display device 1616 may comprise an alphanumeric display device such as an LCD display device. The display device 1616 can also include a sound output device such as a speaker or a buzzer. Display device 1616 is operated and controlled by controller 1122 according to an operating program or algorithm corresponding to a device attached to flexible shaft 1620, such as surgical device 11, for example. If no surgical device or accessory is attached, a default operating program or algorithm can be read by being selected by or transmitted to the controller 1122, thereby operating the display device 1616, As well as other aspects and functions of the electromechanical drive component 1610. When the surgical device 11 is attached to the flexible shaft 1620, the display device 1616, as described more fully above, for example, the first jaw 50 and the second determined according to the output signals of the encoders 1106, 1108, for example. Data indicating the gap between the chin portions 80 can be displayed.

  Similarly, indicators 1618a, 1618b are operated and controlled by controller 1122 according to an operating program or algorithm corresponding to a device attached to flexible shaft 1620, such as surgical device 11, for example. Indicator 1618a and / or indicator 1618b may comprise an acoustic output device such as a speaker, a buzzer, and / or a visual indicator device such as an LED, lamp, light. When the surgical device 11 is attached to the flexible shaft 1620, the indicator 1618a can indicate, for example, that the electromechanical drive component 1610 is in a power-on state, and the indicator 1618b can be, for example, a first Whether the gap between the jaw portion 50 and the second jaw portion 80 has been determined to be within an acceptable range can be displayed. Although two indicators 1618a, 1618b are described, it should be understood that any number of additional indicators may be provided as needed. Furthermore, although a single display device 1616 is described, it should be understood that any number of additional display devices may be provided as needed.

  The display device 1616 ′ and indicators 1618a ′, 1618b ′ of the wired RCU 1150 and the display device 1616 ″ and indicators 1618a ″, 1618b ″ of the wireless RCU 1148 are flexible shafts by respective controllers 1322, 1322 ′. The device attached to 1620 is similarly operated and controlled according to an operating program or algorithm.

  As specified above, one problem with conventional surgical devices, particularly the conventional linear clamping, cutting, and stapling device as shown in FIG. 1, is that the opposing jaws are placed in the patient. It is difficult to operate. In order to place the desired tissue between the opposing jaws, the surgeon may need to move the opposing jaws at various angles. However, it may also be desirable to make the patient's incision as small as possible at the same time, limiting the angle at which the opposing jaws are manipulated by the small size incision. Exemplary embodiments of the present invention can provide improved operability of a surgical device such as surgical device 11 in a patient, for example.

  Another problem with conventional surgical devices, particularly the aforementioned linear clamping, cutting and stapling devices as shown in FIG. 1, is that the opposing jaws may not be sufficiently hemostatic It is. In particular, the opposing jaws of the aforementioned surgical device may not be clamped together with sufficient force, thereby reducing the effectiveness of the surgical device. Exemplary embodiments of the present invention can provide improved tightening of a portion of tissue disposed between jaws such as a surgical device, e.g., surgical device 11, thereby sufficient for a tightened portion of tissue. Causes a hemostatic condition.

  Further, as indicated above, one problem with conventional cutting and stapling devices is that the opposing jaws of the mechanism cannot properly clamp the portion of tissue clamped between them, and the operation of the device The portion of tissue clamped in between cannot be prevented from deviating from between the distal end of the jaw. The conventional clamping, cutting and stapling device scissor-type gripping elements, such as the device shown in FIG. 1, pivot relative to each other about a fixed pivot point at the proximal end of the gripping element So this happens. Thus, since the distance between the grasping elements is always less at the proximal end of the grasping element than at the distal end of the grasping element, the clamping force on the portion of tissue disposed between the grasping elements is It is maximal near the proximal end and gradually decreases in the distal direction. Due to the relatively high clamping force at the proximal end of the grasping element coupled with the relatively low clamping force at the distal end of the grasping element, the portion of tissue is moved between the distal end of the grasping element. Pushed and finally pushed out of it. Thus, a portion of tissue may be properly cut and cannot be stapled, and the end of the tissue that is improperly cut and stapled causes its contents to flow into the patient's open abdomen. May increase the likelihood of infection and other problems.

  On the other hand, as described in detail above with reference to FIGS. Of the surgical device 11 so that the clamping force between the distal ends 50a, 80a is greater than the clamping force between the distal ends of the jaws of a conventional clamping, cutting and stapling device. A mechanism may be provided in which the distal ends 50a, 80a of the first and second jaws 50, 80 are pushed toward each other during operation. The increased clamping force at the distal ends 50a, 80a of the first and second jaws 50, 80 causes the portion of tissue disposed between the first and second jaws 50, 80 to be the first. Further, deviation from between the distal end portions 50a and 80a of the second jaw portions 50 and 80 can be prevented.

  Those skilled in the art will appreciate that many modifications can be made to the exemplary embodiments described above without departing from the spirit and scope of the invention. While exemplary embodiments of the present invention have been described and disclosed in detail herein, it should be understood that the invention is in no way limited thereby.

1 is a perspective view of a conventional clamping, cutting and stapling device. FIG. 1 is a perspective view of an exemplary embodiment of an electromechanical drive component according to the present invention. FIG. FIG. 3 is a schematic diagram illustrating some of the components of a surgical device according to an exemplary embodiment of the present invention. 1 is a perspective view of a surgical device according to an exemplary embodiment of the present invention. FIG. FIG. 3 is a rear perspective view showing some of the internal components of a surgical device according to an exemplary embodiment of the present invention. FIG. 3 is a side perspective view showing some of the internal components of a surgical device according to an exemplary embodiment of the present invention. FIG. 6 is a perspective view of a fully pivoted jaw portion, eg, articulated with respect to a shaft portion, according to one exemplary embodiment of the present invention. FIG. 6 is a bottom perspective view showing a jaw portion, for example, fully pivoted with respect to a shaft portion, according to one exemplary embodiment of the present invention. 1 is an exploded view of a replaceable staple cartridge according to an exemplary embodiment of the present invention. FIG. 1 is a cross-sectional view of a surgical device in a fully closed position according to one exemplary embodiment of the present invention. FIG. FIG. 6 is a bottom view of a first jaw portion according to another exemplary embodiment of the present invention. FIG. 6 is a side sectional view showing opening and closing of first and second jaw portions according to another embodiment of the present invention. FIG. 6 is a side sectional view showing opening and closing of first and second jaw portions according to another embodiment of the present invention. FIG. 6 is a side sectional view showing opening and closing of first and second jaw portions according to another embodiment of the present invention. FIG. 6 is a side sectional view showing opening and closing of first and second jaw portions according to another embodiment of the present invention. FIG. 6 is a perspective view of an articulating, clamping, cutting and stapling attachment device according to another exemplary embodiment of the present invention. FIG. 6 is a perspective view illustrating another feature of the second jaw portion of the jaw portion according to an exemplary embodiment of the present invention. FIG. 6 is a perspective view showing the proximal end of the second jaw portion of the jaw portion according to an exemplary embodiment of the present invention. Fig. 4b shows the surgical device of Fig. 4a when moved to a first partially closed position. FIG. 4b shows the surgical device of FIG. 4a when moved to a second partially closed position. Fig. 4b shows the surgical device of Fig. 4a when moved to a fully closed position. FIG. 3 shows a flexible shaft and a first coupling according to an exemplary embodiment of the present invention. 2 is a rear perspective view of a first coupling according to an exemplary embodiment of the present invention. FIG. 6b is a front perspective view of the first coupling according to the exemplary embodiment shown in FIG. 6b. FIG. FIG. 3 is a side perspective view of several internal components of a first coupling according to an exemplary embodiment of the present invention. FIG. 8 is a second coupling rear perspective view of the distal end of a flexible shaft according to an exemplary embodiment of the present invention. FIG. 4 is a partially cross-sectional side view of a flexible shaft according to another exemplary embodiment of the present invention. FIG. 8 is a cross-sectional view of the flexible shaft taken along line 8-8 shown in FIG. FIG. 3 is a rear end view of a first coupling according to one exemplary embodiment of the present invention. FIG. 6 is a second coupling front end view of the distal end of a flexible shaft according to an exemplary embodiment of the present invention. 2 is a schematic diagram of an arrangement of motors according to an exemplary embodiment of the present invention. FIG. FIG. 2 is a schematic diagram of an electromechanical drive component according to an exemplary embodiment of the present invention. FIG. 2 is a schematic diagram of an encoder according to an exemplary embodiment of the present invention. 2 is a schematic diagram of a memory module according to an exemplary embodiment of the present invention. FIG. 1 is a schematic diagram of a wireless RCU according to an exemplary embodiment of the present invention. FIG. FIG. 3 is a schematic diagram of a wired RCU according to an exemplary embodiment of the present invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 11 Surgical device 11a Chin part 11c Hinge part 11b Shaft part 50 1st jaw part 50a Distal end part 50b Proximal end part 52 Tissue 80 2nd jaw part 80a Distal end part 80b Proximal end part 88 1st Drive unit 94 First drive shaft 96 First motor 98 Second drive unit 100 Second motor 102 Second drive shaft 104 Stapling element 106 Tightening surface 108 Tightening surface 201 Third drive unit 202 Fourth Drive unit 301 Drive element 302 Tightening element 303 Rotating shaft 500 Drive shaft 502 Gear element 504 Gear element 505 Pin 506 Gear element 508 Shaft 510 Gear element 512 Gear element 513 Pin 514 Gear element 516 Teeth 518 Plate 520 Screw 522 Roller block 524 Roller 0 Drive shaft 552 Gear element 554 Gear element 556 Gear element 558 Shaft 560 Gear element 562a Gear element 562b Gear element 564 Gear element 566 Rod 568 Rod 574 Distal end 600 Staple cartridge 603 Wedge 603a Bore 603b Edge tray 604 604b orifice 604d proximal end 604e central channel 604f slot 604g wall 604h slot 604i slot 605 wedge drive 605b region 605c portion 605d opening 606 staple 606a butt 607b prong 607 staple pusher 607b Housing 626 second Pull ring 653 Contact surface 654 First drive socket 654 Tail region 672 Shoulder 694 Second drive socket 700 Anvil member 701 Slot 702 Row 703 Staple guide 713 Quick connect sleeve 713a Quick connect slot 1101 Distal part 1102 Proximal part 1103 Handle 1104 Connection element 1106 Encoder 1108 Second encoder 1110 Line 1112 Line 1116 Line 1118 Line 1122 Controller 1124 Line 1126 Line 1128 Line 1128 Line 1130 Memory Unit 1132 ROM Component 1134 RAM Component 1136 Line 1138 Line 1140 Transceiver 1142 Line 1144 Line 1146 Receive / Transmission unit 1148 Wireless RCU
1150 Wired RCU
1154 Line 1156 Line 1158 Line 1160 Wireless Link 1180 Serial Number Data 1182 ID Data 1184 Usage Data 1186 Switch Device 1188 Line 1242 N-Pole 1244 S-Pole 1246 First Sensor 1248 Second Sensor 1272 Data Connector 1276 Contact 1278 Data Transfer Cable 1300 Steering control device 1302 Multiple switches 1304 Multiple switches 1306 Multiple switches 1308 Multiple switches 1310 Four-way rocker 1312 Engagement / engagement switch 1314 Two-way rocker 1316 First switch 1318 Second switch 1322 Controller 1332 Line 1334 line 1336 line 1338 transceiver 1340 line 1342 receiver / transmit 1346 Switch 1348 Line 1610 Drive Component 1612 Housing 1614 Housing 1615 Front Panel 1616 Display Device 1616 ′ Display Device 1618a Display 1618a Display 1618b Display 1618b ′ Display 1620 Drive Shaft 1622 First Coupling 1624 Distal End 1624 1626 2nd coupling 1628 Sheath 1634 1st steering cable 1635 2nd steering cable 1636 3rd steering cable 1637 4th steering cable 1638 Data transfer cable 1640 Inner channel 1642 Key structure 1644 Connector 1646 Recess 1648 Connector 1650 Recess 1652 Connector 1654 Recess 1656 Connector 1658 Recess 1660 Data connector 1662 Contact portion 1664 Quick connection element 1666 First connector 1668 Second connector 1670 Data connector 1672 Contact portion 1654 Key structure 1678 Output shaft 1678 Electric motor 1686 Output shaft 1688 Pulley mechanism 1690 Electric motor 1692 Output shaft 1694 Pulley mechanism 1696 Electric motor 1698 Output shaft 2011 3rd drive socket 2012 3rd drive shaft 2013 3rd motor 2021 4th drive socket 2022 4th drive shaft 2023 4th motor 2620 Shaft 2622 1st cup Ring 2624 Distal end 2626 Second coupling 3011 Opening 3021 Proximal end 3022 Intermediate portion 3023 Distal end 3031 distal end 3032 proximal end 5011 slot 5012 pivot pin 5013 slot 5661 teeth 6041 memory module 6042 memory module retainer

Claims (60)

A jaw portion comprising a first jaw portion and a second jaw portion movable relative to the first jaw portion, the jaw portion comprising a first longitudinal axis;
A shaft portion coupled to a proximal end of the jaw portion, the shaft portion defining a second longitudinal axis;
A drive configured to pivot at least a portion of the jaw portion relative to the shaft portion about the first longitudinal axis, wherein the drive portion further moves the jaw portion to the second portion; A surgical device comprising a drive configured to pivot relative to the shaft portion about a pivot axis perpendicular to the longitudinal axis.   The device of claim 1, wherein the pivot axis is also perpendicular to the first longitudinal axis.   The device of claim 2, wherein the first and second jaws are movable relative to each other in one plane, and the pivot axis is disposed parallel to the plane.   4. A device according to claim 3, wherein the drive is adapted to be driven by a first rotatable drive shaft and a second rotatable drive shaft.   The drive portion is configured such that the jaw portion pivots about the pivot axis relative to the shaft portion by rotating the first and second rotatable drive shafts in opposite directions relative to each other. 5. The device of claim 4, wherein:   The drive is configured to be rotated in the same direction relative to each other by the first and second rotatable drive shafts so that the at least a portion of the jaw portion is the first longitudinal axis. 6. The device of claim 5, wherein the device is rotated relative to the shaft portion about.   The drive unit is configured to be rotated by the first rotatable drive shaft without rotation of the second rotatable drive shaft, whereby the first jaw and the second The device according to claim 6, wherein the jaw part is relatively moved.   The device of claim 7, further comprising a surgical member disposed within the first jaw.   The device of claim 8, wherein the surgical member comprises at least one of a cutting element and a stapling element.   The drive unit is configured to be rotated by the second rotatable drive shaft without rotation of the first rotatable drive shaft, whereby the surgical member is moved within the first jaw portion. The device according to claim 9, wherein the device is relatively moved.   The first rotatable drive shaft is configured to rotate in a first direction to pivot the jaw portion about the pivot axis in a first pivot direction relative to the shaft portion; A second rotatable drive shaft is configured to rotate in a second direction opposite to the first direction, and the jaw portion is rotated about the pivot axis in a second direction opposite to the first pivot direction. The first rotatable drive shaft is configured to rotate in the second direction so that the second rotatable drive shaft is rotated in the second direction. The device of claim 5, wherein the device is configured to rotate in one direction.   The first and second rotatable drive shafts are first to rotate the at least a portion of the jaw relative to the shaft portion in a first rotational direction about the first longitudinal axis. And at least a portion of the jaw is rotated about the first longitudinal axis relative to the shaft portion in a second rotational direction opposite the first rotational direction. The device of claim 6, wherein the first and second rotatable drive shafts are configured to rotate in a second direction opposite to the first direction.   The first rotatable drive shaft is configured to rotate in a first direction, and the second rotatable drive shaft opens the first jaw with respect to the second jaw. The first rotatable drive shaft is configured to rotate in a second direction opposite to the first direction, and the second rotatable drive shaft is configured to prevent the first rotatable drive shaft from rotating. 8. The device of claim 7, wherein the device is configured not to rotate to close the first jaw relative to a second jaw.   The second rotatable drive shaft is configured to rotate in a first direction, and the first rotatable drive shaft is configured not to rotate to extend the surgical member; Two rotatable drive shafts are configured to rotate in a second direction opposite to the first direction so that the first rotatable drive shaft does not rotate to retract the surgical member. The device of claim 10, wherein the device is configured.   The device of claim 4, further comprising an electromechanical drive configured to rotate the first and second rotatable drive shafts.   The device of claim 15, wherein the electromechanical drive comprises the first and second rotatable drive shafts.   The device of claim 16, wherein the electromechanical drive comprises at least one motor mechanism adapted to drive each of the first and second rotatable drive shafts.   The electromechanical drive unit is configured to drive a first motor mechanism configured to drive the first rotatable drive shaft, and a second configured to drive a second rotatable drive shaft. The device of claim 17, comprising a motor mechanism. A jaw portion comprising a first jaw portion and a second jaw portion movable relative to the first jaw portion, the jaw portion defining a first longitudinal axis;
A shaft portion coupled to a proximal end of the jaw portion, the shaft portion defining a second longitudinal axis;
At least a first rotatable drive shaft configured to rotate at least a portion of the jaw portion about the first longitudinal axis relative to the shaft portion; A surgical device further comprising: a drive configured to pivot the jaw portion relative to the shaft portion about a pivot axis perpendicular to the second longitudinal axis.   The device of claim 19, wherein the pivot axis is also perpendicular to the first longitudinal axis.   21. The device of claim 20, wherein the first and second jaws are movable relative to each other in one plane and the pivot axis is disposed parallel to the plane.   Further comprising a second rotatable drive shaft, wherein the drive is configured to be rotated in opposite directions relative to each other by the first and second rotatable drive shafts. The device of claim 21, wherein the portion is pivoted relative to the shaft portion about the pivot axis.   The drive is configured to be rotated in the same direction relative to each other by the first and second rotatable drive shafts so that the at least a portion of the jaw portion is the first longitudinal axis. 23. The device of claim 22, wherein the device is rotated relative to the shaft portion about.   The drive unit is configured to be rotated by the first rotatable drive shaft without rotation of the second rotatable drive shaft, whereby the first jaw and the second 24. The device of claim 23, wherein the jaws are moved relative to each other.   25. The device of claim 24, further comprising a surgical member disposed within the first jaw.   26. The device of claim 25, wherein the surgical member comprises at least one of a cutting element and a stapling element.   The drive unit is configured to be rotated by the second rotatable drive shaft without rotation of the first rotatable drive shaft, whereby the surgical member is moved within the first jaw portion. 27. The device of claim 26, wherein the device is relatively moved.   The first rotatable drive shaft is configured to rotate in a first direction to pivot the jaw portion about the pivot axis in a first pivot direction relative to the shaft portion; A second rotatable drive shaft is configured to rotate in a second direction opposite to the first direction, and the jaw portion is rotated about the pivot axis in a second direction opposite to the first pivot direction. The first rotatable drive shaft is configured to rotate in the second direction so that the second rotatable drive shaft is rotated in the second direction. The device of claim 19, wherein the device is configured to rotate in one direction.   The first and second rotatable drive shafts are configured to rotate the at least a portion of the jaw relative to the shaft portion in a first rotational direction about the first longitudinal axis; Configured to rotate in a direction of 1, wherein at least a portion of the jaw is rotated relative to the shaft portion about the first longitudinal axis in a second rotational direction opposite to the first rotational direction. 26. The device of claim 25, wherein the first and second rotatable drive shafts are configured to rotate in a second direction opposite to the first direction.   The first rotatable drive shaft is configured to rotate in a first direction, and the second rotatable drive shaft opens the first jaw with respect to the second jaw. The first rotatable drive shaft is configured to rotate in a second direction opposite to the first direction, and the second rotatable drive shaft is configured to prevent the first rotatable drive shaft from rotating. 30. The device of claim 29, configured to not rotate to close the first jaw relative to a second jaw.   The second rotatable drive shaft is configured to rotate in a first direction, and the first rotatable drive shaft is configured not to rotate to extend the surgical member; Two rotatable drive shafts are configured to rotate in a second direction opposite to the first direction so that the first rotatable drive shaft does not rotate to retract the surgical member. 32. The device of claim 30, wherein the device is configured.   The device of claim 19, further comprising an electromechanical drive configured to rotate the first and second rotatable drive shafts.   33. The device of claim 32, wherein the electromechanical drive comprises the first and second rotatable drive shafts.   34. The device of claim 33, wherein the electromechanical drive comprises at least one motor mechanism adapted to drive each of the first and second rotatable drive shafts.   The electromechanical drive unit is configured to drive a first motor mechanism configured to drive the first rotatable drive shaft, and a second configured to drive a second rotatable drive shaft. 35. The device of claim 34, comprising a motor mechanism.   35. The device of claim 34, wherein the motor mechanism is part of a motor system.   40. The device of claim 36, further comprising a control system configured to control the motor system.   38. The device of claim 37, wherein the control system is disposed within a housing.   40. The device of claim 38, further comprising a remote control unit adapted to communicate with the control system to control the motor system via the control system.   40. The device of claim 39, wherein the remote control unit comprises at least one of a wired remote control unit and a wireless remote control unit.   20. The device of claim 19, further comprising a sensor corresponding to the first rotatable drive shaft, wherein the sensor outputs a corresponding signal in response to rotation of the first rotatable drive shaft. .   42. The control system is configured to determine at least one of a rotational position and a rotational direction of the first rotatable drive shaft based on the output signal of the sensor. Devices.   38. The device of claim 37, wherein the control system comprises a first memory unit.   The first memory unit is configured to store a plurality of operating programs, wherein at least one of the operating programs is attached to the cutting and stapling device attached to the distal end of the elongate shaft. 44. The device of claim 43, corresponding.   The control system is configured to identify the surgical instrument attached to a distal end of the elongate shaft as the cutting and stapling device, wherein the cutting and stapling device is the elongate One of a plurality of types of surgical instruments attachable to the distal end of a shaft, the control system from the first memory unit corresponding to the cutting and stapling device to the operating 45. The device of claim 44, configured to perform at least one of reading and selecting a program.   A surgical instrument attached to the elongate shaft, wherein the control system is configured to attach the cutting and stapling device according to data read from a second memory unit disposed in the cutting and stapling device. 46. The device of claim 45, configured to identify as a type of In a method of operating a surgical device, the surgical device has a jaw portion comprising a first jaw portion and a second jaw portion movable with respect to the first jaw portion, the jaw portion being A method comprising a first longitudinal axis, wherein the surgical device further comprises a shaft portion comprising a second longitudinal axis,
Pivoting at least a portion of the jaw portion with respect to the shaft portion about the longitudinal axis via a drive, and with respect to the shaft portion about a pivot axis perpendicular to the second longitudinal axis. Turning the jaw part.   48. The method of claim 47, wherein the pivot axis is also perpendicular to the first longitudinal axis.   49. The method of claim 48, further comprising moving the first and second jaws relative to each other in one plane, wherein the pivot axis is disposed parallel to the plane.   50. The method of claim 49, further comprising driving the drive with a first rotatable drive shaft and a second rotatable drive shaft.   The method further comprises rotating the first and second rotatable drive shafts in opposite directions relative to each other to pivot the jaw portion relative to the shaft portion about the pivot axis. 50. The method according to 50.   Rotating the first and second rotatable drive shafts in the same direction relative to each other to rotate at least a portion of the jaw portion relative to the shaft portion about the first longitudinal axis 52. The method of claim 51, further comprising a step.   The method further comprises rotating the first rotatable drive shaft without rotation of the second rotatable drive shaft to move the first jaw portion and the second jaw portion relative to each other. Item 53. The method according to Item 52.   Rotating the second rotatable drive shaft without rotation of the first rotatable drive shaft for relative movement of the surgical member within the first jaw, the surgical member comprising: 54. The method of claim 53, comprising at least one of a cutting element and a stapling element. A jaw portion comprising a first jaw portion and a second jaw portion movable relative to the first jaw portion, wherein the jaw portion defines a first longitudinal axis and the surgical member is the A chin portion disposed in the first chin portion;
A shaft portion coupled to a proximal end of the jaw portion, the shaft portion defining a second longitudinal axis;
Selective rotation of the first and second rotatable drive shafts causes at least a portion of the jaw portion to pivot relative to the shaft portion about the first longitudinal axis, and the jaw portion is Swiveling relative to the shaft portion about a swivel axis perpendicular to a second longitudinal axis, moving the first jaw relative to the second jaw, and within the first jaw A surgical device comprising: a drive unit adapted to be driven by the first and second rotatable drive shafts for relative movement of the surgical member.   The drive is configured to be driven by rotating in the same direction relative to each other by the first and second rotatable drive shafts, wherein the at least part of the jaw portion is in the first longitudinal direction. 56. The surgical device of claim 55, wherein the surgical device is rotated relative to the shaft portion about an axis.   The drive portion is configured to be driven by rotating the first and second rotatable drive shafts in opposite directions with respect to each other, the jaw portion being pivoted about a pivot axis relative to the shaft portion 56. The surgical device of claim 55, wherein the surgical device is swiveled.   The drive portion is configured to be driven by the first rotatable drive shaft without rotation of the second rotatable drive shaft, and the first jaw portion and the second jaw portion are 56. The surgical device of claim 55, wherein the surgical device is relatively moved.   The drive unit is configured to be driven by rotation by the second rotatable drive shaft without rotation of the first rotatable drive shaft, and the surgical member is relatively moved within the first jaw portion. 56. The surgical device of claim 55, wherein the surgical device is moved.   56. The device of claim 55, wherein the surgical member comprises at least one of a cutting element and a stapling element.

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